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General NPI Number Information
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NPI Number | 1245944453
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Entity Type | Individual
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Provider Name | AMANDA LUISA GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 01/11/2023
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 13340 METRO PKWY STE 400
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City | FORT MYERS
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State | FL
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Zip | 33966-4818
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Country | US
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Telephone | 239-343-1105
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Fax | 239-343-4259
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Provider Business Mailing Address
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Address Line | PO BOX 2147
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City | FORT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone | 239-343-1105
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Fax | 239-343-4259
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN1104332
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | RN9527732
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License Number State | FL
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