Individual
MIRANDA LEA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 W SR 436 STE 2015, ALTAMONTE SPRINGS, FL 32714-3053
(407) 285-4789
Mailing address
801 W SR 436 STE 2015, ALTAMONTE SPRINGS, FL 32714-3053
(407) 285-4789
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
238214
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
238214
—
FL
Enumeration date
02/02/2022
Last updated
02/02/2022
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