Healthcare Provider Details

I. General information

NPI: 1790094670
Provider Name (Legal Business Name): MARIA ROSARIO GONZALEZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2010
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 SW 29TH CT
MIAMI FL
33135-4518
US

IV. Provider business mailing address

1045 SW 29TH CT
MIAMI FL
33135-4518
US

V. Phone/Fax

Practice location:
  • Phone: 786-553-0527
  • Fax:
Mailing address:
  • Phone: 786-553-0527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11032026
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW159
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: