Individual
LISSETT GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1219 LINTON AVE, ORLANDO, FL 32809-6372
(407) 485-4358
Mailing address
1219 LINTON AVE, ORLANDO, FL 32809-6372
(407) 485-4358
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
G524520777520
FL
Other
Enumeration date
04/18/2022
Last updated
04/18/2022
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