Individual provider Active NPI

Addy Gonzalez Gonzalez

  • Speech-Language Pathologist
  • Miami Lakes, FL
National Provider Identifier
1346053782
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SI5380 Issued in FL
Practice address
15346 NW 79TH CT
Miami Lakes, FL 33016-5850
Phone
(786) 486-0936
NPI assigned
Jan 29, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SI5380 FL Primary

Addresses

Primary practice location

15346 NW 79TH CT
Miami Lakes, FL 33016-5850

Mailing address

1310 W 38TH St
Hialeah, FL 33012-4775
Phone (786) 486-0936

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
SI5380FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1346053782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W 38TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124775",
            "telephone_number": "786-486-0936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15346 NW 79TH CT",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165850",
            "telephone_number": "786-486-0936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ GONZALEZ",
        "first_name": "ADDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SI5380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.