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NPI Code Detail

MEDICARE: JOSE A GONZALEZ RN

MEDICARE:   JOSE A GONZALEZ  RN
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
1163W00000XRegistered Nurse10381PR

General Provider Information

NPI Number : 1134510142
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE A GONZALEZ RN
Provider Business Mailing Address
First Line : 3321 NW 23RD CT
Second Line :
City : LAUD LAKES
State : FL
Zip : 33311-2742
Country : US
Telephone Number : 786-838-8701
Fax Number :
Provider Business Practice Location Address
First Line : 3321 NW 23RD CT
Second Line :
City : LAUD LAKES
State : FL
Zip : 33311-2742
Country : US
Telephone Number : 786-838-8701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2015
Last Update Date : 02/12/2015

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Directions to “ JOSE A GONZALEZ RN” Practice Location

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