Healthcare Provider Details

I. General information

NPI: 1619883212
Provider Name (Legal Business Name): FRANCISCO MIGUEL GONZALEZ HERNANDEZ NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9310 N CENTRAL AVE STE 1
PHOENIX AZ
85020-2418
US

IV. Provider business mailing address

4027 W CAMINO ACEQUIA
PHOENIX AZ
85051-1064
US

V. Phone/Fax

Practice location:
  • Phone: 480-610-6100
  • Fax:
Mailing address:
  • Phone: 786-792-8943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3212329
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: