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NPI Code Detail

MEDICARE: MS. ODALYS GONZALEZ FNP

MEDICARE:  MS. ODALYS  GONZALEZ  FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner0001333279VA

General Provider Information

NPI Number : 1215883798
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ODALYS GONZALEZ FNP
Provider Business Mailing Address
First Line : 1307 GILMORE ST
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-5362
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1307 GILMORE ST
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-5362
Country : US
Telephone Number : 504-521-4656
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2026
Last Update Date : 03/07/2026

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Directions to “ MS. ODALYS GONZALEZ FNP” Practice Location

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