MEDICARE: MR. FRANKLIN ERNESTO GONZALEZ

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	225700000X	Massage Therapist	MA50242	FL

General Provider Information

NPI Number	:	1205023942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRANKLIN ERNESTO GONZALEZ

Provider Business Mailing Address
First Line	:	2500 RANCHLAND ST
Second Line	:
City	:	INVERNESS
State	:	FL
Zip	:	34453-3301
Country	:	US
Telephone Number	:	352-454-0162
Fax Number	:	352-344-2943

Provider Business Practice Location Address
First Line	:	2232 HIGHWAY 44 W
Second Line	:
City	:	INVERNESS
State	:	FL
Zip	:	34453-3860
Country	:	US
Telephone Number	:	352-454-0162
Fax Number	:	352-344-2943

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

Provider Enumeration Date	:	09/26/2007
Last Update Date	:	09/26/2007

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Directions to “ MR. FRANKLIN ERNESTO GONZALEZ ” Practice Location

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