Healthcare Provider Details

I. General information

NPI: 1669337846
Provider Name (Legal Business Name): ROCIO ADELAYS BEOVIDES GONZALEZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 DARLINGTON OAK DR
SEFFNER FL
33584-5486
US

IV. Provider business mailing address

2045 DARLINGTON OAK DR
SEFFNER FL
33584-5486
US

V. Phone/Fax

Practice location:
  • Phone: 813-298-9654
  • Fax:
Mailing address:
  • Phone: 813-298-9654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11044270
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: