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NPI Code Detail

MEDICARE: MARIA DE JESUS GONZALEZ

MEDICARE: MARIA DE JESUS GONZALEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistPT 14991FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PT 14991OTHERFLLICENSE NUMBER

General Provider Information

NPI Number : 1902852924
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARIA DE JESUS GONZALEZ
Provider Business Mailing Address
First Line : 6043 NW 167TH ST
Second Line : SUITE A11
City : MIAMI
State : FL
Zip : 33015-4326
Country : US
Telephone Number : 305-231-1544
Fax Number :
Provider Business Practice Location Address
First Line : 6043 NW 167TH ST
Second Line : SUITE A11
City : MIAMI
State : FL
Zip : 33015-4326
Country : US
Telephone Number : 305-231-1544
Fax Number :
Authorized Official
Title or Position : PHYSICAL THERAPIST
Name : MARIA DE JESUS GONZALEZ
Credential : PHYSICAL THERAPIST
Telephone Number : 305-231-1544
Provider Enumeration Date : 05/25/2006
Last Update Date : 08/22/2020

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Directions to “MARIA DE JESUS GONZALEZ ” Practice Location

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