Provider Demographics
NPI:1871638098
Name:GONZALEZ POUZA, ROXANA MARIA (MAC)
Entity Type:Individual
Prefix:MRS
First Name:ROXANA
Middle Name:MARIA
Last Name:GONZALEZ POUZA
Suffix:
Gender:F
Credentials:MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7550 SW 57TH AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5331
Mailing Address - Country:US
Mailing Address - Phone:305-669-6699
Mailing Address - Fax:305-940-0059
Practice Address - Street 1:7550 SW 57TH AVE STE 116
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5331
Practice Address - Country:US
Practice Address - Phone:305-669-6699
Practice Address - Fax:305-940-0059
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1387171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist