Individual
JACLYN MARIE GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
12450 SW 7TH PL, DAVIE, FL 33325-3400
(954) 288-9466
Mailing address
12450 SW 7TH PL, DAVIE, FL 33325-3400
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3233
FL
Other
Enumeration date
12/28/2017
Last updated
12/28/2017
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