Individual ProviderIlineis GonzalezBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address14932 SW 30th Ter, Miami, FL 33185(305) 915-4721PECOS EnrollmentBased on the most recent information from CMS, provider Ilineis Gonzalez 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 ID1346768314Provider TypeIndividualFull NameGonzalez, IlineisGenderFemaleSole ProprietorYesEnumeration Date8/30/2017Last Updated7/21/2022Contact InformationPractice LocationPractice Address14932 SW 30th Ter, Miami, FL 33185Phone(305) 915-4721Fax(305) 742-2190Mailing LocationMailing Address14932 SW 30th Ter, Miami, FL 33185-4842Phone(305) 915-4721Fax(305) 742-2190Provider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode103K00000XDescriptionBehavior AnalystBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer