Provider Demographics
NPI:1467655993
Name:GONZALEZ, CINDY (LMT)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9507 NW 80TH PL
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-1309
Mailing Address - Country:US
Mailing Address - Phone:954-263-2098
Mailing Address - Fax:
Practice Address - Street 1:10617 W ATLANTIC BLVD # 100
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-5610
Practice Address - Country:US
Practice Address - Phone:954-263-2098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA37772225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist