Provider Demographics
NPI:1871135558
Name:GONZALEZ SALAZAR, YANAY (OTR)
Entity type:Individual
Prefix:
First Name:YANAY
Middle Name:
Last Name:GONZALEZ SALAZAR
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 SE 8TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-3211
Mailing Address - Country:US
Mailing Address - Phone:786-239-0343
Mailing Address - Fax:
Practice Address - Street 1:1100 HOMESTEAD RD N STE D
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-6008
Practice Address - Country:US
Practice Address - Phone:239-491-2901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-14
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17067224Z00000X
FLOT23885225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant