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General NPI Number Information
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NPI Number | 1366028110
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Entity Type | Individual
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Provider Name | MABIT C GONZALEZ MD
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Gender | Female
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Dates
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Enumeration Date | 03/22/2021
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 822B N JOHN YOUNG PKWY
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City | KISSIMMEE
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State | FL
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Zip | 34741-4912
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Country | US
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Telephone | 855-501-1004
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Fax |
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Provider Business Mailing Address
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Address Line | 3835 N FREEWAY BLVD STE 100
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City | SACRAMENTO
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State | CA
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Zip | 95834-1954
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Country | US
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Telephone | 916-576-7900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME170236
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License Number State | FL
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