Provider Demographics
NPI:1336774785
Name:GONZALEZ, CLAUDIA CRISTINA
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:CRISTINA
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 1:9321 NW 42ND CT
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5920
Mailing Address - Country:US
Mailing Address - Phone:954-274-1914
Mailing Address - Fax:
Practice Address - Street 1:9321 NW 42ND CT
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-5920
Practice Address - Country:US
Practice Address - Phone:954-295-5428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-05
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator