Individual
JORGE GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
346 ASHLEY LOOP, DAVENPORT, FL 33837-8820
(863) 852-5964
Mailing address
346 ASHLEY LOOP, DAVENPORT, FL 33837-8820
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 57837
FL
Other
Enumeration date
03/02/2010
Last updated
03/02/2010
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