Provider Demographics
NPI:1912652868
Name:REMEDIOZ GONZALEZ, YURI
Entity Type:Individual
Prefix:
First Name:YURI
Middle Name:
Last Name:REMEDIOZ GONZALEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 NW 7TH ST STE 610
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3437
Mailing Address - Country:US
Mailing Address - Phone:786-505-9442
Mailing Address - Fax:
Practice Address - Street 1:5040 NW 7TH ST STE 610
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3437
Practice Address - Country:US
Practice Address - Phone:786-505-9442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-18
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL363LP0808X.363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health