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NPI Code Detail

MEDICARE: MISS IRMA COLUMBIA GONZALEZ ARNP

MEDICARE: MISS IRMA COLUMBIA GONZALEZ ARNP
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
1363LF0000XFamily Nurse Practitioner9360180FL
2363LF0000XFamily Nurse PractitionerARNP9360180FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AG1109500OTHERFLBOARD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285140095
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS IRMA COLUMBIA GONZALEZ ARNP
Provider Business Mailing Address
First Line : 121 S ORANGE AVE STE 940
Second Line :
City : ORLANDO
State : FL
Zip : 32801-3234
Country : US
Telephone Number : 407-658-9687
Fax Number : 407-286-4515
Provider Business Practice Location Address
First Line : 810 N NOWELL ST
Second Line :
City : ORLANDO
State : FL
Zip : 32808-7539
Country : US
Telephone Number : 407-290-9556
Fax Number : 407-290-9509
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2017
Last Update Date : 03/17/2018

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