Provider Demographics
NPI:1457112997
Name:GONZALEZ- HERNANDEZ, DANIELA (MS-SLP)
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:GONZALEZ- HERNANDEZ
Suffix:
Gender:F
Credentials:MS-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CENTERPLEX BUILDING CARR. # 2 KM.133.5
Mailing Address - Street 2:201
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602
Mailing Address - Country:US
Mailing Address - Phone:787-589-8800
Mailing Address - Fax:
Practice Address - Street 1:CARR. # 2 KM.133.5 SUITE 201
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-589-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4535235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist