Individual
ELEIDA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
606 3RD ST, POLK CITY, FL 33868-9051
(267) 474-5064
Mailing address
606 3RD ST, POLK CITY, FL 33868-9051
(267) 474-5064
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/09/2017
Last updated
11/09/2017
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