MARISSA GONZALEZ NPI 1124742135

NPI Information

  • NPI: 1124742135
  • Provider Name: MARISSA GONZALEZ
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 7901 4TH ST N STE 300
    ST PETERSBURG, FL
    ZIP 33702
  • Phone: (904) 560-5652

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NPI Details

Marissa Gonzalez is a family nurse practitioner in St Petersburg, FL with 4 years of experience. Marissa Gonzalez NPI is 1124742135. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

7901 4TH ST N STE 300
ST PETERSBURG, FL
ZIP 33702-399
Phone: (904) 560-5652
Fax: (904) 734-3973

The NPI 1124742135 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 10/3/2022 and was last updated on 8/8/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse Practitioner11022258FLORIDANo
2363LF0000XNurse PractitionerFamily11022258FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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