Individual
MISS AMANDA MICHELLE GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14121 SW 17TH ST, DAVIE, FL 33325-5933
(954) 579-2866
Mailing address
14121 SW 17TH ST, DAVIE, FL 33325-5933
(954) 579-2866
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SZ5796
FL
Other
Enumeration date
06/26/2012
Last updated
06/26/2012
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