Provider Demographics
NPI:1396351110
Name:GONZALEZ, CLAUDIA B
Entity type:Individual
Prefix:MISS
First Name:CLAUDIA
Middle Name:B
Last Name:GONZALEZ
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 1:7819 N DALE MABRY HWY STE 104
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-3210
Mailing Address - Country:US
Mailing Address - Phone:813-898-0912
Mailing Address - Fax:813-898-0743
Practice Address - Street 1:7819 N DALE MABRY HWY STE 104
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3210
Practice Address - Country:US
Practice Address - Phone:813-898-0912
Practice Address - Fax:813-898-0743
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-17
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center