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General NPI Number Information
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NPI Number | 1235842261
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Entity Type | Individual
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Provider Name | GLEMNYS GONZALEZ CASAL PTA
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Gender | Female
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Dates
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Enumeration Date | 01/04/2023
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 13707 KENDALE LAKES CIR APT 410
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City | MIAMI
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State | FL
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Zip | 33183-2240
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Country | US
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Telephone | 305-926-3063
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Fax |
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Provider Business Mailing Address
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Address Line | 13707 KENDALE LAKES CIR APT 410
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City | MIAMI
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State | FL
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Zip | 33183-2240
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Country | US
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Telephone | 305-926-3063
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA29699
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License Number State | FL
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