Healthcare Provider Details

I. General information

NPI: 1568101384
Provider Name (Legal Business Name): CHRISTINA GONZALEZ M.A., CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 05/31/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OAKWOOD BLVD STE 130
HOLLYWOOD FL
33020-1937
US

IV. Provider business mailing address

8951 NW 5TH ST
PEMBROKE PINES FL
33024-6405
US

V. Phone/Fax

Practice location:
  • Phone: 954-925-3844
  • Fax:
Mailing address:
  • Phone: 954-670-6101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: