Provider Demographics
NPI:1720329196
Name:GONZALEZ, LUISA FERNANDA (PT, MSPT)
Entity type:Individual
Prefix:
First Name:LUISA
Middle Name:FERNANDA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PT, MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11660 ALPHARETTA HWY STE 115
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-3872
Mailing Address - Country:US
Mailing Address - Phone:770-992-4001
Mailing Address - Fax:770-992-4095
Practice Address - Street 1:11660 ALPHARETTA HWY STE 115
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-3872
Practice Address - Country:US
Practice Address - Phone:770-740-8592
Practice Address - Fax:770-752-9478
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA011159225100000X
GAPT011159225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist