Provider Demographics
NPI:1033692314
Name:GONZALEZ, ANA CECILIA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:CECILIA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15932 75TH LN N
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-3141
Mailing Address - Country:US
Mailing Address - Phone:561-201-7917
Mailing Address - Fax:561-584-5033
Practice Address - Street 1:15932 75TH LN N
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-3141
Practice Address - Country:US
Practice Address - Phone:561-201-7917
Practice Address - Fax:561-584-5033
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist