Provider Demographics
NPI:1992188627
Name:GONZALEZ GOTAY, MARIA CRISTINA (MD)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:CRISTINA
Last Name:GONZALEZ GOTAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 MEDICAL CT E
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-4612
Mailing Address - Country:US
Mailing Address - Phone:352-726-7667
Mailing Address - Fax:352-726-8193
Practice Address - Street 1:800 MEDICAL CT E
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4612
Practice Address - Country:US
Practice Address - Phone:352-726-7667
Practice Address - Fax:352-726-8193
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR32033-R207V00000X
390200000X
FLME141074207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty