Healthcare Provider Details

I. General information

NPI: 1922928993
Provider Name (Legal Business Name): THALIA GONZALEZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 SW 8TH ST
CORAL GABLES FL
33134-2400
US

IV. Provider business mailing address

4950 SW 8TH ST
CORAL GABLES FL
33134-2400
US

V. Phone/Fax

Practice location:
  • Phone: 305-882-9504
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN32290
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: