Provider Demographics
NPI:1104173442
Name:GONZALEZ, CARMEN ARLENE (PSY D)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:ARLENE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 PARK TREE TER APT 822
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-3465
Mailing Address - Country:US
Mailing Address - Phone:321-695-0835
Mailing Address - Fax:
Practice Address - Street 1:509 STREET OU20
Practice Address - Street 2:COUNTRY CLUB
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-1901
Practice Address - Country:US
Practice Address - Phone:787-590-5101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4273103TC0700X
FL0103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical