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NPI Code Detail

MEDICARE: DUSTIN GONZALEZ PT, DPT

MEDICARE: DUSTIN GONZALEZ PT, DPT
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
1225100000XPhysical TherapistPT36664FL

General Provider Information

NPI Number : 1073119020
Entity Type Code : Individual
Provider Name (Legal Business Name) : DUSTIN GONZALEZ PT, DPT
Provider Business Mailing Address
First Line : 1500 N UNIVERSITY DR STE 101
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33071-6071
Country : US
Telephone Number : 954-458-1199
Fax Number : 877-349-0255
Provider Business Practice Location Address
First Line : 805 SE 3RD AVE STE 2
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33316-1193
Country : US
Telephone Number : 954-256-9052
Fax Number : 954-256-9053
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2020
Last Update Date : 04/30/2026

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Directions to “ DUSTIN GONZALEZ PT, DPT” Practice Location

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