Healthcare Provider Details

I. General information

NPI: 1598017378
Provider Name (Legal Business Name): JESSICA GONZALEZ MURO CSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2012
Last Update Date: 10/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 N STATE ROAD 7 STE B
ROYAL PALM BEACH FL
33411-3504
US

IV. Provider business mailing address

10131 FOREST HILL BLVD STE 230
WELLINGTON FL
33414-6109
US

V. Phone/Fax

Practice location:
  • Phone: 561-798-6600
  • Fax: 561-615-1958
Mailing address:
  • Phone: 561-798-6600
  • Fax: 561-615-1958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: