Provider Demographics
NPI:1760670061
Name:GONZALEZ, VICTORIA JULIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:JULIE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:VICTORIA
Other - Middle Name:JULIE
Other - Last Name:DODMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:17773 SW 2ND ST.
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029
Mailing Address - Country:US
Mailing Address - Phone:786-470-5850
Mailing Address - Fax:
Practice Address - Street 1:17773 SW 2ND ST.
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029
Practice Address - Country:US
Practice Address - Phone:786-470-5850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7572103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical