Provider Demographics
NPI:1669738555
Name:GONZALEZ, MALAYKA (FSLMT, AAPSY, RCA)
Entity type:Individual
Prefix:MS
First Name:MALAYKA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:FSLMT, AAPSY, RCA
Other - Prefix:MS
Other - First Name:MALAYKA
Other - Middle Name:
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FREEMAN
Mailing Address - Street 1:6560 MITCHELWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-8638
Mailing Address - Country:US
Mailing Address - Phone:321-200-4920
Mailing Address - Fax:
Practice Address - Street 1:672 N SEMORAN BLVD STE 201
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3372
Practice Address - Country:US
Practice Address - Phone:407-757-3515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFS869881174400000X, 174400000X
FLMA53515225700000X, 225700000X, 173C00000X
2471C3402X, 2472D0500X, 171M00000X, 171R00000X, 106E00000X, 106S00000X, 175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No174400000XOther Service ProvidersSpecialist
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography
No2472D0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherDarkroom
No173C00000XOther Service ProvidersReflexologist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No171R00000XOther Service ProvidersInterpreter
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No175T00000XOther Service ProvidersPeer Specialist