Healthcare Provider Details

I. General information

NPI: 1174434161
Provider Name (Legal Business Name): ASHLEY DENISE GONZALEZ A.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2217 SE 30TH ST
HOMESTEAD FL
33035-2031
US

IV. Provider business mailing address

2217 SE 30TH ST
HOMESTEAD FL
33035-2031
US

V. Phone/Fax

Practice location:
  • Phone: 786-902-1508
  • Fax:
Mailing address:
  • Phone: 786-902-1508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP4789
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: