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NPI Code Detail

MEDICARE: NAMIVIAN GONZALEZ GUTIERREZ APRN

MEDICARE:   NAMIVIAN  GONZALEZ GUTIERREZ  APRN
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 Practitioner11011727FL
2363LF0000XFamily Nurse PractitionerAPRN11011727FL

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 : 1568055515
Entity Type Code : Individual
Provider Name (Legal Business Name) : NAMIVIAN GONZALEZ GUTIERREZ APRN
Provider Business Mailing Address
First Line : 3145 S CONGRESS AVE STE A
Second Line :
City : PALM SPRINGS
State : FL
Zip : 33461-2553
Country : US
Telephone Number : 561-559-2371
Fax Number : 561-530-4540
Provider Business Practice Location Address
First Line : 3145 S CONGRESS AVE STE A
Second Line :
City : PALM SPRINGS
State : FL
Zip : 33461-2553
Country : US
Telephone Number : 561-559-2371
Fax Number : 561-530-4540
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2021
Last Update Date : 06/06/2024

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Directions to “ NAMIVIAN GONZALEZ GUTIERREZ APRN” Practice Location

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