Healthcare Provider Details

I. General information

NPI: 1891332839
Provider Name (Legal Business Name): GRETERLY CARRAZANA-GOMEZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GRETERLY CARRAZANA

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
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

4881 NW 8TH AVE SUITE 2
GAINESVILLE FL
32605-4582
US

V. Phone/Fax

Practice location:
  • Phone: 352-401-8817
  • Fax: 352-401-8822
Mailing address:
  • Phone: 352-416-1082
  • Fax: 352-373-6144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11003691
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: