Provider Demographics
NPI:1679390959
Name:URICARI GONZALEZ, CARLOS JULIO (SA-C)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:JULIO
Last Name:URICARI GONZALEZ
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 SOLE MIA WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2492
Mailing Address - Country:US
Mailing Address - Phone:305-243-5000
Mailing Address - Fax:
Practice Address - Street 1:2111 SOLE MIA WAY
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2492
Practice Address - Country:US
Practice Address - Phone:305-243-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant