Provider Demographics
NPI:1609380716
Name:GONZALEZ, VERONICA A (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:A
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10449 SW 23RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7931
Mailing Address - Country:US
Mailing Address - Phone:305-206-9031
Mailing Address - Fax:
Practice Address - Street 1:9425 SW 72ND ST STE 225
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5494
Practice Address - Country:US
Practice Address - Phone:786-953-8389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-28
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLSZ10489235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty