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General NPI Number Information
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NPI Number | 1679771505
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Entity Type | Individual
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Provider Name | MRS. VIRGILIA M GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 10/24/2013
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Provider Practice Location Address
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Address Line | 8900 SW 117TH AVE STE B-104
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City | MIAMI
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State | FL
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Zip | 33186-2175
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Country | US
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Telephone | 305-279-0159
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Fax | 786-263-0179
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Provider Business Mailing Address
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Address Line | 8900 SW 117TH AVE STE B-104
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City | MIAMI
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State | FL
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Zip | 33186-2175
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Country | US
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Telephone | 305-279-0159
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Fax | 786-263-0179
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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 | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | RN2152962
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License Number State | FL
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