Provider Demographics
NPI:1295354694
Name:GONZALEZ, MARIA DEL ROCIO
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DEL ROCIO
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 N 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30705-2409
Mailing Address - Country:US
Mailing Address - Phone:706-280-6137
Mailing Address - Fax:
Practice Address - Street 1:4510 CHARLOTTE AVE APT 323
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-3893
Practice Address - Country:US
Practice Address - Phone:706-280-6137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program