Provider Demographics
NPI:1821248253
Name:GONZALEZ-GARCIA, ADRIANA (MSCP, MBA)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:GONZALEZ-GARCIA
Suffix:
Gender:F
Credentials:MSCP, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4488 LOWER PARK RD UNIT 3406
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6399
Mailing Address - Country:US
Mailing Address - Phone:407-924-3210
Mailing Address - Fax:
Practice Address - Street 1:2122 POINCIANA RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-1827
Practice Address - Country:US
Practice Address - Phone:407-924-3210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008489800Medicaid