Healthcare Provider Details

I. General information

NPI: 1386227015
Provider Name (Legal Business Name): ADIANEZ GONZALEZ SANCHEZ MSN, APRN , FNP - C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2021
Last Update Date: 09/14/2024
Certification Date: 09/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11431 GREEN HARVEST DR
RIVERVIEW FL
33578-6178
US

IV. Provider business mailing address

525 TECHNOLOGY PARK STE 109
LAKE MARY FL
32746-7107
US

V. Phone/Fax

Practice location:
  • Phone: 813-327-0910
  • Fax:
Mailing address:
  • Phone: 813-327-0910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number1101290
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN1102490
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: