Individual
ITZA MARIE NIEVES GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
427 BURNS AVE, LAKE WALES, FL 33853-3314
(863) 679-3338
Mailing address
427 ROOKS LOOP, HAINES CITY, FL 33844-3425
(863) 679-3338
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI7690
FL
Other
Enumeration date
12/19/2025
Last updated
12/19/2025
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