Healthcare Provider Details

I. General information

NPI: 1831019470
Provider Name (Legal Business Name): MARIA GONZALEZ FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 LONGVIEW LN
PALM COAST FL
32137-9730
US

IV. Provider business mailing address

9 LONGVIEW LN
PALM COAST FL
32137-9730
US

V. Phone/Fax

Practice location:
  • Phone: 386-569-1914
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2026041182
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: