Healthcare Provider Details

I. General information

NPI: 1669419479
Provider Name (Legal Business Name): MARIA ELIZABETH FLORES-GONZALEZ CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13838 SW 53RD ST
MIRAMAR FL
33027-5942
US

IV. Provider business mailing address

13838 SW 53RD ST
MIRAMAR FL
33027-5942
US

V. Phone/Fax

Practice location:
  • Phone: 305-829-7130
  • Fax: 305-829-7131
Mailing address:
  • Phone: 305-829-7130
  • Fax: 305-829-7131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374T00000X
TaxonomyReligious Nonmedical Nursing Personnel
License NumberARPN 9208933
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: