Provider Demographics
NPI:1225328404
Name:GONZALEZ, ARIEL III (MASSAGE THERAPY)
Entity Type:Individual
Prefix:MR
First Name:ARIEL
Middle Name:
Last Name:GONZALEZ
Suffix:III
Gender:M
Credentials:MASSAGE THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8181 NW 36TH STREET EXT
Mailing Address - Street 2:SUITE 9A
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6671
Mailing Address - Country:US
Mailing Address - Phone:305-599-3294
Mailing Address - Fax:305-599-3295
Practice Address - Street 1:8181 NW 36TH STREET EXT
Practice Address - Street 2:SUITE 9A
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6671
Practice Address - Country:US
Practice Address - Phone:305-599-3294
Practice Address - Fax:305-599-3295
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA60320261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy