Provider Demographics
NPI:1629206867
Name:GONZALEZ, OLGA LUCIA (DPM)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:LUCIA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14201 PARK CENTER DR STE 410
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5251
Mailing Address - Country:US
Mailing Address - Phone:301-498-0340
Mailing Address - Fax:
Practice Address - Street 1:14201 PARK CENTER DR STE 410
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5251
Practice Address - Country:US
Practice Address - Phone:301-498-0340
Practice Address - Fax:301-618-0594
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASC006115213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist