Healthcare Provider Details

I. General information

NPI: 1679329106
Provider Name (Legal Business Name): GLORIAMARIA GONZALEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2024
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

10600 CHESTER AVE APT 1815
CLEVELAND OH
44106-0220
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-9393
  • Fax: 216-444-3310
Mailing address:
  • Phone: 216-352-9046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberAPP-000836368
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberAPP-000836368
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberAPP-000836368
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: