Healthcare Provider Details

I. General information

NPI: 1689078164
Provider Name (Legal Business Name): MARIA M GONZALEZ DE TORRES DBH, LCSW, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIA MAIDA ELENA COLON LCSW, MSW

II. Dates (important events)

Enumeration Date: 10/13/2014
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1197
US

IV. Provider business mailing address

800 SE 1ST ST
WILLISTON FL
32696-3040
US

V. Phone/Fax

Practice location:
  • Phone: 352-548-6000
  • Fax:
Mailing address:
  • Phone: 352-260-2063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW12014
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: