Individual provider Active NPI

Luis Alejandro Gonzalez Gonzalez

  • Physical Therapist
  • Boca Raton, FL
National Provider Identifier
1245110014
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTT43736 Issued in FL
Practice address
3848 Fau Blvd Ste 105
Boca Raton, FL 33431-6437
Phone
(561) 997-5210
NPI assigned
Sep 3, 2025
Last updated
Nov 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTT43736 FL Primary
Physical Therapist 225100000X PT018118 GA

Addresses

Primary practice location

3848 Fau Blvd Ste 105
Boca Raton, FL 33431-6437

Mailing address

40 W Lake Pass
Newnan, GA 30263-4666

Other practice location 1

147 Reinhard Colg Pkwy Ste 9
Canton, GA 30114-5295
Phone (770) 345-3057

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

LicenseStateTypeSpecialty
PTT43736FLMDPhysical Therapist
PT018118GAMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1245110014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W LAKE PASS",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302634666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3848 FAU BLVD STE 105",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316437",
            "telephone_number": "561-997-5210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 Reinhard Colg Pkwy Ste 9",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301145295",
            "country_code": "US",
            "telephone_number": "770-345-3057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ GONZALEZ",
        "first_name": "LUIS",
        "middle_name": "ALEJANDRO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PTT43736",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT018118",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.