Provider Demographics
NPI:1821412628
Name:GONZALEZ, FRANCISCO
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 CENTER ST BLDG 2
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-1071
Mailing Address - Country:US
Mailing Address - Phone:440-279-1700
Mailing Address - Fax:440-286-7106
Practice Address - Street 1:470 CENTER ST BLDG 2
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-1071
Practice Address - Country:US
Practice Address - Phone:440-279-1700
Practice Address - Fax:440-286-7106
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT.005858225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist