Active NPI
Luiciana Massiel Gonzalez
- Dentist
- Riverview, FL
National Provider Identifier
1619737111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN30533
- Practice address
- 11104 Bloomingdale Ave
Riverview, FL 33578-3717 - Phone
- (813) 413-5063
- NPI assigned
- Mar 21, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN30533 | FL | Primary |
Addresses
Primary practice location
11104 Bloomingdale Ave
Riverview, FL 33578-3717
Mailing address
1237 Parnell St
Haines City, FL 33844-9446
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN30533 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750723200000",
"number": "1619737111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1237 PARNELL ST",
"city": "HAINES CITY",
"state": "FL",
"postal_code": "338449446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11104 BLOOMINGDALE AVE",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335783717",
"telephone_number": "813-413-5063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "LUICIANA",
"middle_name": "MASSIEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-21",
"last_updated": "2025-06-24",
"certification_date": "2025-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN30533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.