MEDICARE: DR. CYNTHIA ALEXANDRA GONZALEZ DAT, ATC

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
1	225400000X	Rehabilitation Practitioner	AL5416	FL

General Provider Information

NPI Number	:	1174995369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA ALEXANDRA GONZALEZ DAT, ATC

Provider Business Mailing Address
First Line	:	2125 W HIAWATHA ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-5732
Country	:	US
Telephone Number	:	561-667-2030
Fax Number	:

Provider Business Practice Location Address
First Line	:	2125 W HIAWATHA ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-5732
Country	:	US
Telephone Number	:	561-667-2030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2015
Last Update Date	:	02/18/2026

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