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Individual

HAZEL GONZALEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1301 W MAITLAND BLVD, MAITLAND, FL 32751-4338
(407) 645-3990
(352) 382-1146
Mailing address
8477 S SUNCOAST BLVD, HOMOSASSA, FL 34446-5028
(800) 804-9961
(352) 382-1146

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA17726
FL
225200000X
Physical Therapy Assistant
Primary
PTA18845
FL

Other

Enumeration date
11/30/2021
Last updated
11/30/2021
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