Healthcare Provider Details

I. General information

NPI: 1083369581
Provider Name (Legal Business Name): LAUREN NUNEZ GOLD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2022
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10244 S US HIGHWAY 1
PORT ST LUCIE FL
34952-5615
US

IV. Provider business mailing address

9 SIMARA ST
STUART FL
34996-6326
US

V. Phone/Fax

Practice location:
  • Phone: 866-228-7676
  • Fax:
Mailing address:
  • Phone: 561-629-2026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11015923
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11015923
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: