Provider Demographics
NPI:1033982905
Name:GONZALEZ, MARIANA BEATRIZ (APRN)
Entity Type:Individual
Prefix:
First Name:MARIANA
Middle Name:BEATRIZ
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9950 SHERIDAN ST APT 206
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3052
Mailing Address - Country:US
Mailing Address - Phone:305-985-9431
Mailing Address - Fax:
Practice Address - Street 1:9950 SHERIDAN ST APT 206
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3052
Practice Address - Country:US
Practice Address - Phone:305-985-9431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11029551363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily