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Individual

LEONARDO GONZALEZ BAHAMONDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2808 LITHIA PINECREST RD, VALRICO, FL 33596-5615
(813) 573-2905
Mailing address
902 ESSEX RD, BRANDON, FL 33510-2735

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA32051
FL

Other

Enumeration date
09/14/2022
Last updated
09/14/2022
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