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NPI Code Detail

MEDICARE: MRS. DENISSE VIVIANN GONZALEZ M.A., CCC/SLP

MEDICARE: MRS. DENISSE VIVIANN GONZALEZ M.A., CCC/SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSA 9993FL

General Provider Information

NPI Number : 1033347901
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DENISSE VIVIANN GONZALEZ M.A., CCC/SLP
Provider Business Mailing Address
First Line : 3181 AQUA VIRGO LOOP
Second Line :
City : ORLANDO
State : FL
Zip : 32837-4029
Country : US
Telephone Number : 407-319-1871
Fax Number :
Provider Business Practice Location Address
First Line : 14055 TOWN LOOP BLVD STE 300
Second Line :
City : ORLANDO
State : FL
Zip : 32837-6106
Country : US
Telephone Number : 407-857-6285
Fax Number : 407-857-9566
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2009
Last Update Date : 02/03/2016

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Directions to “ MRS. DENISSE VIVIANN GONZALEZ M.A., CCC/SLP” Practice Location

Language Start Address Practice Location
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