Provider Demographics
NPI:1558332049
Name:GONZALEZ, GLORIA E (PT)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:E
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 CORAL WAY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145
Mailing Address - Country:US
Mailing Address - Phone:305-285-5500
Mailing Address - Fax:305-285-7950
Practice Address - Street 1:2000 CORAL WAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145
Practice Address - Country:US
Practice Address - Phone:305-285-5500
Practice Address - Fax:305-285-7950
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT8851225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE8284AOtherMEDICARE LEGACY
FLE8284AMedicare PIN
FLE8284AOtherMEDICARE LEGACY