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General NPI Number Information
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NPI Number | 1497272603
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Entity Type | Individual
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Provider Name | HERNAN JOSUE GONZALEZ FNP
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Gender | Male
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Dates
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Enumeration Date | 08/28/2017
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Last Update Date | 02/26/2023
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Provider Practice Location Address
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Address Line | 16903 LAKESIDE DR STE 4D
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City | MONTVERDE
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State | FL
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Zip | 34756-3241
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Country | US
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Telephone | 407-426-4337
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Fax |
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Provider Business Mailing Address
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Address Line | 588 BRANTLEY TERRACE WAY UNIT 205
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-0834
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Country | US
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Telephone | 407-795-2956
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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 | ARNP9418709
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License Number State | FL
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