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NPI Code Detail

MEDICARE: DORALIS GONZALEZ PELEGRIN NP

MEDICARE: DORALIS GONZALEZ PELEGRIN NP
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 Practitioner5023974NC

General Provider Information

NPI Number : 1992664684
Entity Type Code : Individual
Provider Name (Legal Business Name) : DORALIS GONZALEZ PELEGRIN NP
Provider Business Mailing Address
First Line : 645 N MAIN ST
Second Line :
City : HIGH POINT
State : NC
Zip : 27260-5017
Country : US
Telephone Number : 336-883-0029
Fax Number : 336-883-0867
Provider Business Practice Location Address
First Line : 5093 UNIVERSITY PKWY
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27106-6085
Country : US
Telephone Number : 336-883-0029
Fax Number : 336-883-0867
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2026
Last Update Date : 06/09/2026

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