Provider Demographics
NPI:1447841663
Name:GONZALEZ, MADAIVY (HHA-CNA)
Entity type:Individual
Prefix:
First Name:MADAIVY
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:HHA-CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2880 SW 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3984
Mailing Address - Country:US
Mailing Address - Phone:786-479-3048
Mailing Address - Fax:
Practice Address - Street 1:2880 SW 67TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3984
Practice Address - Country:US
Practice Address - Phone:786-479-3048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-30
Last Update Date:2021-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide