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NPI Code Detail

MEDICARE: STEPHANIE KAY GONZALEZ FNP-BC

MEDICARE: STEPHANIE KAY GONZALEZ FNP-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
1363LF0000XFamily Nurse Practitioner71005521AIN
2363LF0000XFamily Nurse PractitionerAPRN9480590FL

Other Identifiers

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

General Provider Information

NPI Number : 1427441856
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE KAY GONZALEZ FNP-BC
Provider Business Mailing Address
First Line : 10854 GORDEN SETTER DR
Second Line :
City : OSCEOLA
State : IN
Zip : 46561-8538
Country : US
Telephone Number : 574-540-6349
Fax Number :
Provider Business Practice Location Address
First Line : 111 LAKE HOLLINGSWORTH DR
Second Line :
City : LAKELAND
State : FL
Zip : 33801-5607
Country : US
Telephone Number : 863-687-1376
Fax Number : 863-687-1377
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2015
Last Update Date : 07/30/2022

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