=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093578635
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YORDANIA GONZALEZ
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/05/2024
-----------------------------------------------------
Last Update Date | 08/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 704 GOODLETTE-FRANK RD N STE 306
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34102-5644
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-601-6151
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 704 GOODLETTE-FRANK RD N STE 306
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34102-5644
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-601-6151
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Nurse Practitioner
-----------------------------------------------------
License Number | 11030856
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------