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General NPI Number Information
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NPI Number | 1033880679
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Entity Type | Individual
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Provider Name | CHRISTOPHER GONZALEZ OTD
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Gender | Male
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Dates
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Enumeration Date | 09/23/2021
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 2639 W SR 434
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City | LONGWOOD
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State | FL
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Zip | 32779-4878
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Country | US
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Telephone | 321-972-8326
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Fax |
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Provider Business Mailing Address
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Address Line | 16453 NW 83RD PL
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City | MIAMI LAKES
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State | FL
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Zip | 33016-3469
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Country | US
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Telephone | 786-261-7636
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT21876
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License Number State | FL
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