Provider Demographics
NPI:1306477187
Name:GONZALEZ, FRANCISCA SUSANA
Entity type:Individual
Prefix:
First Name:FRANCISCA
Middle Name:SUSANA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8704 NW 147TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33018-7372
Mailing Address - Country:US
Mailing Address - Phone:305-915-7392
Mailing Address - Fax:
Practice Address - Street 1:8704 NW 147TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33018-7372
Practice Address - Country:US
Practice Address - Phone:305-915-7392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17733101YM0800X
1041C0700X
FL17733101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical