Healthcare Provider Details

I. General information

NPI: 1043901887
Provider Name (Legal Business Name): CATHERINE MARIA GONZALEZ OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 LIGHTHOUSE DR
BRADENTON FL
34212-2168
US

IV. Provider business mailing address

8212 ABALONE LOOP
PARRISH FL
34219-1749
US

V. Phone/Fax

Practice location:
  • Phone: 941-213-0762
  • Fax: 941-241-4045
Mailing address:
  • Phone: 973-903-8507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC6269
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: