Provider Demographics
NPI:1003589029
Name:MORA GONZALEZ, BARBARA LUCIA (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:LUCIA
Last Name:MORA GONZALEZ
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 1:1161 21ST AVENUE S
Mailing Address - Street 2:MCN A-2206
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232
Mailing Address - Country:US
Mailing Address - Phone:806-317-2634
Mailing Address - Fax:
Practice Address - Street 1:1161 21ST AVENUE S
Practice Address - Street 2:MCN A-2206
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232
Practice Address - Country:US
Practice Address - Phone:806-317-2634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2024-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program