Healthcare Provider Details

I. General information

NPI: 1396634556
Provider Name (Legal Business Name): CECILIA GONZALEZ TORRES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 66TH ST N
PINELLAS PARK FL
33781-5030
US

IV. Provider business mailing address

6500 66TH ST N
PINELLAS PARK FL
33781-5030
US

V. Phone/Fax

Practice location:
  • Phone: 813-499-1500
  • Fax: 813-499-1499
Mailing address:
  • Phone: 813-499-1500
  • Fax: 813-499-1499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11040607
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: