Provider Demographics
NPI:1912704024
Name:GONZALEZ CHAVEZ, LORELY (SLPA)
Entity type:Individual
Prefix:
First Name:LORELY
Middle Name:
Last Name:GONZALEZ CHAVEZ
Suffix:
Gender:
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5817 W 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-4735
Mailing Address - Country:US
Mailing Address - Phone:786-583-1070
Mailing Address - Fax:
Practice Address - Street 1:5817 W 26TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-4735
Practice Address - Country:US
Practice Address - Phone:786-582-0282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL75562355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant