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NPI Code Detail

MEDICARE: MARISOL GONZALEZ APRN

MEDICARE: MARISOL GONZALEZ 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
1363LG0600XGerontology Nurse PractitionerAPRN11001420FL

General Provider Information

NPI Number : 1679138226
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISOL GONZALEZ APRN
Provider Business Mailing Address
First Line : 1605 W FAIRBANKS AVE
Second Line :
City : WINTER PARK
State : FL
Zip : 32789-4603
Country : US
Telephone Number : 407-845-8356
Fax Number :
Provider Business Practice Location Address
First Line : 1605 W FAIRBANKS AVE
Second Line :
City : WINTER PARK
State : FL
Zip : 32789-4603
Country : US
Telephone Number : 407-845-8356
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2019
Last Update Date : 12/16/2025

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Directions to “ MARISOL GONZALEZ APRN” Practice Location

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