Provider Information for 1609390426
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MAYLIN GONZALEZ M.S
Sex: Female
NPI: 1609390426
Last Updated: 2024-01-24
Certification Date: 2024-01-24
Certification Date: 2024-01-24
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1609390426 | ||||||||||||||||||||
| Enumeration Date | 2017-08-02 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 330 W 46TH ST HIALEAH, FL 33012-3947 United States Phone: 786-365-6235 | Fax: | ||||||||||||||||||||
| Primary Practice Address | 9900 STIRLING RD STE 103 HOLLYWOOD, FL 33024-8073 United States Phone: 954-300-2921 | Fax:954-529-2001 | ||||||||||||||||||||
| Secondary Practice Address(es) | 4649 PONCE DE LEON BLVD STE 404 | ||||||||||||||||||||
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