Healthcare Provider Details
I. General information
NPI: 1942048954
Provider Name (Legal Business Name): CHRISTOPHER GOSS MSN, FNP-C, RN, CNOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/16/2024
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2820 SE 3RD CT STE 200
OCALA FL
34471-0442
US
IV. Provider business mailing address
2820 SE 3RD CT STE 200
OCALA FL
34471-0442
US
V. Phone/Fax
- Phone: 352-401-8817
- Fax:
- Phone: 352-401-8817
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 11033998 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | APRN11033998 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: