Healthcare Provider Details

I. General information

NPI: 1194492090
Provider Name (Legal Business Name): KATHRINE GONZALEZ FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2021
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8354 N DAVIS HWY STE 100
PENSACOLA FL
32514-6584
US

IV. Provider business mailing address

8354 N DAVIS HWY STE 100
PENSACOLA FL
32514-6584
US

V. Phone/Fax

Practice location:
  • Phone: 850-549-4755
  • Fax: 850-549-4760
Mailing address:
  • Phone: 850-547-4755
  • Fax: 850-549-4760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ01136900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11042421
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: