Provider Demographics
NPI:1679116958
Name:GONZALEZ, FRANCISCA
Entity Type:Individual
Prefix:
First Name:FRANCISCA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6554 SWISSCO DR APT 518
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-3216
Mailing Address - Country:US
Mailing Address - Phone:321-418-2749
Mailing Address - Fax:
Practice Address - Street 1:6554 SWISSCO DR APT 518
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-3216
Practice Address - Country:US
Practice Address - Phone:321-418-2749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-19
Last Update Date:2019-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY066-276-752OtherPERMANENT RESIDENT