Healthcare Provider Details

I. General information

NPI: 1912487786
Provider Name (Legal Business Name): JANET LORRAINE GONZALEZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2018
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 MULKEY RD
AUSTELL GA
30106-1112
US

IV. Provider business mailing address

7250 RED BUG LAKE RD STE 1020
OVIEDO FL
32765-9290
US

V. Phone/Fax

Practice location:
  • Phone: 770-732-1137
  • Fax: 770-732-2081
Mailing address:
  • Phone: 407-706-1770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9400244
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: