Provider Demographics
NPI:1366406944
Name:GONZALEZ, RAYDA ESTHER (ARNP,C)
Entity type:Individual
Prefix:MRS
First Name:RAYDA
Middle Name:ESTHER
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:ARNP,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2974 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2827
Mailing Address - Country:US
Mailing Address - Phone:305-631-3000
Mailing Address - Fax:305-631-3006
Practice Address - Street 1:2974 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2827
Practice Address - Country:US
Practice Address - Phone:305-631-3000
Practice Address - Fax:305-631-3006
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1744032363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ51026Medicare UPIN
FLU5753ZMedicare ID - Type Unspecified