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NPI Code Detail

MEDICARE: CARMEN GONZALEZ

MEDICARE:   CARMEN  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
1104100000XSocial WorkerFL
2222Q00000XDevelopmental Therapist

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 : 1467218412
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMEN GONZALEZ
Provider Business Mailing Address
First Line : PO BOX 917770
Second Line :
City : ORLANDO
State : FL
Zip : 32891-0001
Country : US
Telephone Number : 813-821-8038
Fax Number :
Provider Business Practice Location Address
First Line : 13200 MCCORMICK DR STE E-1
Second Line :
City : TAMPA
State : FL
Zip : 33626-3010
Country : US
Telephone Number : 813-814-5971
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2024
Last Update Date : 12/07/2025

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Directions to “ CARMEN GONZALEZ ” Practice Location

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