Gold Coast Evolution Center Inc

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

GOLD COAST EVOLUTION CENTER INC

Practice address

3801 Pga Blvd Ste 600
Palm Beach Gardens, FL 33410-2756

Phone

(305) 496-9661

NPI assigned

Oct 18, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Diana Lina Lezcano Diaz

Title

Ceo

Phone

(305) 496-9661

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1376206359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 PGA BLVD STE 600",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102756",
            "telephone_number": "305-496-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 PGA BLVD STE 600",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102756",
            "telephone_number": "305-496-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD COAST EVOLUTION CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "LEZCANO DIAZ",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "LINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-496-9661"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miles E Glazer, PSY.D
• Glendas Physical Therapy Services, Inc
• Jalan Glover
• Robert C. Go, PTA
• Jennifer Dana Goggin, MA, LMHC, LPC, SEP
• Gold Coast Physical Therapy Associates LLC
• Denise Gold, M.ED
• Karen Gold
• Ashley Nicole Goldbaum
• Bruce A Goldberg, D.C.

• Behavior Analyst in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.