Healthcare Provider Details

I. General information

NPI: 1871899690
Provider Name (Legal Business Name): APRIL R SMITH-GONZALEZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2011
Last Update Date: 12/09/2019
Certification Date: 12/09/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 E MICHIGAN ST SUITE 103
ORLANDO FL
32822-2700
US

IV. Provider business mailing address

5555 E MICHIGAN ST SUITE 103
ORLANDO FL
32822-2700
US

V. Phone/Fax

Practice location:
  • Phone: 407-456-2977
  • Fax:
Mailing address:
  • Phone: 407-456-2977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS11034
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: