Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH 10746 | FL |
N | 111NI0013X | Independent Medical Examiner | CH 10746 | FL |
N | 111NR0400X | Rehabilitation Chiropractor | CH 10746 | FL |
NPI | 1962831289 |
---|---|
Provider Name | Dr. Elizabeth L Gonzalez Bruno |
First Address | Wellington, FL 33414-4385 |
Second Address | Royal Palm Beach, FL 33414-4385 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2013 |
Last Update Date | 06/11/2013 |