Provider Demographics
NPI:1629243811
Name:GONZALEZ-SOLDEVILLA, ANA C (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:C
Last Name:GONZALEZ-SOLDEVILLA
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 1:9221 SW 60TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1636
Mailing Address - Country:US
Mailing Address - Phone:305-798-7286
Mailing Address - Fax:
Practice Address - Street 1:9221 SW 60TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1636
Practice Address - Country:US
Practice Address - Phone:305-798-7286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9784235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist