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General NPI Number Information
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NPI Number | 1407553423
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Entity Type | Individual
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Provider Name | EDGAR GONZALEZ FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 02/09/2023
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 2 N SEMORAN BLVD
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City | ORLANDO
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State | FL
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Zip | 32807-3322
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Country | US
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Telephone | 689-240-4646
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Fax | 866-321-8536
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Provider Business Mailing Address
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Address Line | 4224 ANSON LN APT 103
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City | ORLANDO
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State | FL
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Zip | 32814-6089
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Country | US
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Telephone | 864-764-2375
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Fax |
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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 | 11024520
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License Number State | FL
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