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NPI Code Detail

MEDICARE: TERESA GONZALEZ

MEDICARE: TERESA 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
11041C0700XClinical Social WorkerG255800906420FL
21041C0700XClinical Social WorkerSW13183FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245674878
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA GONZALEZ
Provider Business Mailing Address
First Line : 71 ALAMEDA DR
Second Line :
City : KISSIMMEE
State : FL
Zip : 34743-9201
Country : US
Telephone Number : 407-319-5864
Fax Number :
Provider Business Practice Location Address
First Line : 1621 E VINE ST
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-3730
Country : US
Telephone Number : 407-847-4152
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2013
Last Update Date : 10/01/2025

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Directions to “ TERESA GONZALEZ ” Practice Location

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