Provider Demographics
NPI:1831785708
Name:GONZALES, RHONDA HOPE
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:HOPE
Last Name:GONZALES
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 1:638 CENTERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-2706
Mailing Address - Country:US
Mailing Address - Phone:989-239-7740
Mailing Address - Fax:
Practice Address - Street 1:638 CENTERFIELD DR
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-2706
Practice Address - Country:US
Practice Address - Phone:989-239-7740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH110227444499Medicaid