Healthcare Provider Details

I. General information

NPI: 1548112691
Provider Name (Legal Business Name): ESTHER LIDIA GONZALEZ GONZALEZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9113 SW 162ND CT
MIAMI FL
33196-4926
US

IV. Provider business mailing address

9113 SW 162ND CT
MIAMI FL
33196-4926
US

V. Phone/Fax

Practice location:
  • Phone: 786-774-0375
  • Fax:
Mailing address:
  • Phone: 786-774-0375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11045400
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: