Provider Demographics
NPI:1871474031
Name:GONZALEZ, JACQUELINE
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14064 GOODWIN ST
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:OH
Mailing Address - Zip Code:44021-9522
Mailing Address - Country:US
Mailing Address - Phone:727-263-5124
Mailing Address - Fax:
Practice Address - Street 1:DARWIN 776
Practice Address - Street 2:PISO 4 DEPTO E
Practice Address - City:BUENOS AIRES
Practice Address - State:CABA
Practice Address - Zip Code:C1414CUP
Practice Address - Country:AR
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-11
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter