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General NPI Number Information
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NPI Number | 1669738555
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Entity Type | Individual
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Provider Name | MALAYKA GONZALEZ FSLMT, AAPSY, RCA
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Gender | Female
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Dates
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Enumeration Date | 04/05/2012
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 672 N SEMORAN BLVD STE 201
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City | ORLANDO
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State | FL
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Zip | 32807-3372
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Country | US
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Telephone | 407-757-3515
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Fax |
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Provider Business Mailing Address
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Address Line | 6560 MITCHELWOOD CT
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City | SAINT CLOUD
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State | FL
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Zip | 34771-8638
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Country | US
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Telephone | 321-200-4920
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | FS869881
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA53515
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License Number State | FL
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