Basic Information
Provider Information
NPI: 1407889892
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GONYER
FirstName: KATHRYN
MiddleName: A
NamePrefix: MS.
NameSuffix:  
Credential: MOT/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1601 SW ARCHER RD
Address2: NF/SG VETERANS HEALTH SYSTEM
City: GAINESVILLE
State: FL
PostalCode: 32608
CountryCode: US
TelephoneNumber: 3523761611
FaxNumber:  
Practice Location
Address1: 1601 SW ARCHER RD
Address2: NF/SG VETERANS HEALTH SYSTEM
City: GAINESVILLE
State: FL
PostalCode: 32608
CountryCode: US
TelephoneNumber: 3523761611
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/08/2006
LastUpdateDate: 02/28/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOT11775FLY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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