Healthcare Provider Details

I. General information

NPI: 1396497616
Provider Name (Legal Business Name): ANNIA MARITZA GONZALEZ ARENCIBIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2022
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

394 HAVENDALE BLVD
AUBURNDALE FL
33823-4527
US

IV. Provider business mailing address

6100 BLUE LAGOON DR STE 365
MIAMI FL
33126-7010
US

V. Phone/Fax

Practice location:
  • Phone: 863-327-0131
  • Fax: 863-777-2307
Mailing address:
  • Phone: 786-322-7333
  • Fax: 786-347-5022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberACN1505
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: