Individual
JOHANNA ABADIAS GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
6817 SOUTHPOINT PKWY STE 1602, JACKSONVILLE, FL 32216-6298
(904) 945-7556
(904) 379-0113
Mailing address
1507 CENTER ST, GREEN COVE SPRINGS, FL 32043-2113
(904) 837-8056
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
3264
SC
225XP0200X
Pediatric Occupational Therapist
Primary
OT13260
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0032022269A
—
GA
Enumeration date
08/31/2006
Last updated
08/28/2022
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