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NPI Code Detail

MEDICARE: DR. JOELY AYES-GONZALEZ GNP-C

MEDICARE: DR. JOELY AYES-GONZALEZ GNP-C
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
1363LG0600XGerontology Nurse Practitioner9409894FL

General Provider Information

NPI Number : 1629584289
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOELY AYES-GONZALEZ GNP-C
Provider Business Mailing Address
First Line : 1215 S 25TH ST
Second Line :
City : FORT PIERCE
State : FL
Zip : 34947-4702
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1215 S 25TH ST
Second Line :
City : FORT PIERCE
State : FL
Zip : 34947-4702
Country : US
Telephone Number : 772-468-5925
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2017
Last Update Date : 02/25/2026

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