Provider Demographics
NPI:1700179850
Name:GONZALEZ, KATHERINE WRIGHT (MD)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:WRIGHT
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:WRIGHT
Other - Last Name:SCHNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:501 6TH AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4634
Mailing Address - Country:US
Mailing Address - Phone:727-767-4106
Mailing Address - Fax:727-767-8804
Practice Address - Street 1:501 6TH AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4634
Practice Address - Country:US
Practice Address - Phone:727-767-4106
Practice Address - Fax:727-767-8804
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014015321208600000X
FL135355208600000X
TXBP10041440208600000X
IDM-15191208600000X, 2086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery