Provider Demographics
NPI:1821980210
Name:ORANTES GONZALEZ, NATALIE I
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:I
Last Name:ORANTES GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13276 SW 128TH PSGE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5341
Mailing Address - Country:US
Mailing Address - Phone:786-334-4476
Mailing Address - Fax:
Practice Address - Street 1:12007 SW 114TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-4411
Practice Address - Country:US
Practice Address - Phone:786-334-4476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND12605133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered