Provider Demographics
NPI:1689078164
Name:GONZALEZ DE TORRES, MARIA M (DBH, LCSW, MSW)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:M
Last Name:GONZALEZ DE TORRES
Suffix:
Gender:F
Credentials:DBH, LCSW, MSW
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:MAIDA ELENA
Other - Last Name:COLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, MSW
Mailing Address - Street 1:800 SE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:FL
Mailing Address - Zip Code:32696-3040
Mailing Address - Country:US
Mailing Address - Phone:352-260-2063
Mailing Address - Fax:
Practice Address - Street 1:1601 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1197
Practice Address - Country:US
Practice Address - Phone:352-548-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-13
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW120141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019447400Medicaid