Individual
MARILYN CELINE GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(336) 716-4264
Mailing address
26333 S IVY LN, CHANNAHON, IL 60410-3336
(815) 505-0041
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
06/20/2023
Last updated
10/04/2024
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