Individual
GEORGINA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
900 W 49TH ST, SUITE 410, HIALEAH, FL 33012-3402
(305) 825-2131
(305) 825-2585
Mailing address
4783 E 9TH CT, HIALEAH, FL 33013-2025
(786) 908-2959
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 64101
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA 64101
MASSAGE THERAPIST LICENSE
FL
Enumeration date
01/05/2012
Last updated
01/05/2012
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