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General NPI Number Information
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NPI Number | 1316522683
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Entity Type | Individual
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Provider Name | ALEXA TAYLOR GONZALEZ SLPA
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Gender | Female
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Dates
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Enumeration Date | 03/17/2021
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 6900 TAVISTOCK LAKES BLVD STE 400
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City | ORLANDO
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State | FL
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Zip | 32827-7593
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Country | US
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Telephone | 407-970-0824
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Fax |
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Provider Business Mailing Address
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Address Line | 11751 COLLEGE PARK TRAIL 16-A-D
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City | ORLANDO
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State | FL
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Zip | 32826
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Country | US
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Telephone | 407-946-5244
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State | FL
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