MEDICARE: BARBARA GONZALEZ GARCIA

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	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1891554051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA GONZALEZ GARCIA

Provider Business Mailing Address
First Line	:	3008 W BEACH ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-2929
Country	:	US
Telephone Number	:	813-863-7814
Fax Number	:

Provider Business Practice Location Address
First Line	:	3008 W BEACH ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-2929
Country	:	US
Telephone Number	:	813-863-6656
Fax Number	:

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

Provider Enumeration Date	:	03/18/2024
Last Update Date	:	03/20/2024

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