Healthcare Provider Details

I. General information

NPI: 1184465585
Provider Name (Legal Business Name): ROMINA PAOLA GONZALEZ ZAMBRANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2024
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3120 N MIAMI AVE FL 33127
MIAMI FL
33127-3718
US

IV. Provider business mailing address

1465 JACKSON ST
DUBUQUE IA
52001-4920
US

V. Phone/Fax

Practice location:
  • Phone: 786-724-0418
  • Fax:
Mailing address:
  • Phone: 786-685-6737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN32295
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: