MEDICARE: MRS. MARIA GONZALEZ-GIL C.N.

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
1	133N00000X	Nutritionist	029001	FL

General Provider Information

NPI Number	:	1922301951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA GONZALEZ-GIL C.N.

Provider Business Mailing Address
First Line	:	2333 N.W. 1ST STREET
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125
Country	:	US
Telephone Number	:	786-362-2569
Fax Number	:

Provider Business Practice Location Address
First Line	:	2333 N.W. LST ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125
Country	:	US
Telephone Number	:	786-362-2569
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2010
Last Update Date	:	01/06/2011

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