Individual
MARIA FERNANDA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-4353
(215) 707-2781
Mailing address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-4353
(215) 707-2781
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD451036
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1040220090001
—
PA
Enumeration date
06/17/2009
Last updated
09/09/2022
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