Individual ProviderTania Gonzalez JacominoBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address16331 SW 42nd Ter, Miami, FL 33185-3869(305) 215-6183PECOS EnrollmentBased on the most recent information from CMS, provider Tania Gonzalez Jacomino does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1336722511Provider TypeIndividualFull NameGonzalez Jacomino, TaniaGenderFemaleSole ProprietorYesEnumeration Date5/4/2021Last Updated5/4/2021Contact InformationPractice LocationPractice Address16331 SW 42nd Ter, Miami, FL 33185-3869Phone(305) 215-6183FaxUnlisted FaxMailing LocationMailing Address16331 SW 42nd Ter, Miami, FL 33185-3869Phone(305) 215-6183FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer