Provider Demographics
NPI:1598017378
Name:GONZALEZ MURO, JESSICA (CSA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:GONZALEZ MURO
Suffix:
Gender:F
Credentials:CSA
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Mailing Address - Street 1:10131 FOREST HILL BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6109
Mailing Address - Country:US
Mailing Address - Phone:561-798-6600
Mailing Address - Fax:561-615-1958
Practice Address - Street 1:440 N STATE ROAD 7 STE B
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-3504
Practice Address - Country:US
Practice Address - Phone:561-798-6600
Practice Address - Fax:561-615-1958
Is Sole Proprietor?:No
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
3690OtherNATIONAL SURGICAL ASSISTANT ASSOCIATION