Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marissa Gonzalez

Individual provider Nurse Practitioner · NPI 1124742135

Marissa Gonzalez is a Nurse Practitioner in St Petersburg, Florida. Qualified in 2022, 4 years ago. Licensed in Florida.

Years since qualifying
4
Licensed in
FL
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

7901 4th St N Ste 300
St Petersburg, FL 33702-4399
Phone: (904) 560-5652
Fax: (904) 734-3973
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 11022258 (FL)
Nurse Practitioner Taxonomy 363L00000X · Licence 11022258 (FL)

Record details

NPI number1124742135
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 3, 2022
Last updated in NPPESAugust 8, 2025
Certification dateAugust 8, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated

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