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NPI Code Detail

MEDICARE: CHRISTIAN GONZALEZ

MEDICARE:   CHRISTIAN  GONZALEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1730580622
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN GONZALEZ
Provider Business Mailing Address
First Line : 9585 BACCHUS TRL
Second Line :
City : ORLANDO
State : FL
Zip : 32829-7705
Country : US
Telephone Number : 407-452-9339
Fax Number :
Provider Business Practice Location Address
First Line : 1150 S SEMORAN BLVD STE A
Second Line :
City : ORLANDO
State : FL
Zip : 32807-1424
Country : US
Telephone Number : 407-704-7811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2014
Last Update Date : 05/03/2018

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Directions to “ CHRISTIAN GONZALEZ ” Practice Location

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