Provider Demographics
NPI:1255660908
Name:GONZALEZ, FRANCES (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 NW 126TH AVE
Mailing Address - Street 2:#325
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-6320
Mailing Address - Country:US
Mailing Address - Phone:954-520-1470
Mailing Address - Fax:
Practice Address - Street 1:2925 NW 126TH AVE
Practice Address - Street 2:#325
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-6320
Practice Address - Country:US
Practice Address - Phone:954-520-1470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6606235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL887633900Medicaid