Individual
MS. MARIA D GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST MA
Contact information
Practice address
4578 W 12TH AVE, HIALEAH, FL 33012-3325
(305) 828-1989
Mailing address
4578 W 12TH AVE, HIALEAH, FL 33012-3325
(305) 828-1989
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA67101
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA67101
MASSAGE THERAPIST
FL
Enumeration date
12/07/2017
Last updated
12/07/2017
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