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General NPI Number Information
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NPI Number | 1093471021
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Entity Type | Individual
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Provider Name | GABRIEL L GONZALES DPT
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Gender | Male
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Dates
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Enumeration Date | 11/15/2021
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Last Update Date | 06/06/2022
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Provider Practice Location Address
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Address Line | 14115 TOWN LOOP BLVD STE 200
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City | ORLANDO
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State | FL
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Zip | 32837-4839
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Country | US
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Telephone | 407-601-3922
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Fax |
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Provider Business Mailing Address
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Address Line | 1755 SPLIT FORK DR
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City | OLDSMAR
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State | FL
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Zip | 34677-2768
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Country | US
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Telephone | 813-300-6843
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT37859
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License Number State | FL
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