Healthcare Provider Details

I. General information

NPI: 1053411314
Provider Name (Legal Business Name): YASMIN GONZALEZ OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13000 BRUCE B DOWNS BLVD PM&RS (117) VA HOSPITAL
TAMPA FL
33612-4745
US

IV. Provider business mailing address

13000 BRUCE B DOWNS BLVD PM&RS (117) VA HOSPITAL
TAMPA FL
33612-4745
US

V. Phone/Fax

Practice location:
  • Phone: 813-972-2000
  • Fax: 813-978-5852
Mailing address:
  • Phone: 813-972-2000
  • Fax: 813-978-5852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 2089
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225XE1200X
TaxonomyErgonomics Occupational Therapist
License NumberOT 2089
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License NumberOT 2089
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: