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NPI Code Detail

MEDICARE: KATHIE ANN GONZALES ARNP-BC

MEDICARE: KATHIE ANN GONZALES ARNP-BC
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
1363LA2200XAdult Health Nurse Practitioner3383662FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Y087MOTHERFLBCBSF
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073589214
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHIE ANN GONZALES ARNP-BC
Provider Business Mailing Address
First Line : 24945 US HIGHWAY 19 N
Second Line :
City : CLEARWATER
State : FL
Zip : 33763-3927
Country : US
Telephone Number : 727-726-1460
Fax Number : 727-724-9705
Provider Business Practice Location Address
First Line : 24945 US HIGHWAY 19 N
Second Line :
City : CLEARWATER
State : FL
Zip : 33763-3927
Country : US
Telephone Number : 727-726-1460
Fax Number : 727-724-9705
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2006
Last Update Date : 12/11/2012

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