Active NPI
Antonio Jose Luis Gonzalez
- Massage Therapist
- Green Valley, AZ
National Provider Identifier
1194550889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT27987
- Practice address
- 101 S la Canada Dr Ste 23
Green Valley, AZ 85614-2662 - Phone
- (254) 338-1028
- NPI assigned
- Sep 3, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT27987 | AZ | Primary |
Addresses
Primary practice location
101 S la Canada Dr Ste 23
Green Valley, AZ 85614-2662
Mailing address
210 Calle Arikara
Rio Rico, AZ 85648-2900
Phone (520) 338-5556
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT27987 | AZ | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725321600000",
"number": "1194550889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 CALLE ARIKARA",
"city": "RIO RICO",
"state": "AZ",
"postal_code": "856482900",
"telephone_number": "520-338-5556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 S LA CANADA DR STE 23",
"city": "GREEN VALLEY",
"state": "AZ",
"postal_code": "856142662",
"telephone_number": "254-338-1028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "ANTONIO",
"middle_name": "JOSE LUIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-09-03",
"last_updated": "2024-09-03",
"certification_date": "2024-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AZ",
"license": "MT27987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Valley, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.