Provider Demographics
NPI:1205023942
Name:GONZALEZ, FRANKLIN ERNESTO
Entity Type:Individual
Prefix:MR
First Name:FRANKLIN
Middle Name:ERNESTO
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 RANCHLAND ST
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34453-3301
Mailing Address - Country:US
Mailing Address - Phone:352-454-0162
Mailing Address - Fax:352-344-2943
Practice Address - Street 1:2232 HIGHWAY 44 W
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34453-3860
Practice Address - Country:US
Practice Address - Phone:352-454-0162
Practice Address - Fax:352-344-2943
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA50242225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist