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NPI Code Detail

MEDICARE: DR. LUISA FERNANDA GONZALEZ MD

MEDICARE: DR. LUISA FERNANDA GONZALEZ MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician2025-02383NC
2208000000XPediatrics PhysicianA185706CA

General Provider Information

NPI Number : 1023645637
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LUISA FERNANDA GONZALEZ MD
Provider Business Mailing Address
First Line : PO BOX 7200
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27804-0200
Country : US
Telephone Number : 252-937-0200
Fax Number : 252-451-0056
Provider Business Practice Location Address
First Line : 91 ENTERPRISE DR
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27804-9590
Country : US
Telephone Number : 252-451-3100
Fax Number : 252-937-3106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2020
Last Update Date : 12/16/2025

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