Healthcare Provider Details

I. General information

NPI: 1649787466
Provider Name (Legal Business Name): MAYTEE ZULINA GONZALEZ MSN, APRN, CPN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2018
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3659 S MIAMI AVE STE 3002
MIAMI FL
33133-4225
US

IV. Provider business mailing address

4239 SW 157TH CT
MIAMI FL
33185-3800
US

V. Phone/Fax

Practice location:
  • Phone: 305-858-7940
  • Fax: 305-858-2361
Mailing address:
  • Phone: 786-606-7670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9208278
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: