MEDICARE: ROLANDO GONZALEZ ARIAS 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
1	363L00000X	Nurse Practitioner	APRN11002798	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11002798	FL

General Provider Information

NPI Number	:	1780855866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROLANDO GONZALEZ ARIAS APRN

Provider Business Mailing Address
First Line	:	8620 BYRON AVE APT 10A
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33141-4876
Country	:	US
Telephone Number	:	786-419-7646
Fax Number	:

Provider Business Practice Location Address
First Line	:	13254 SW 8TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33184-1178
Country	:	US
Telephone Number	:	786-419-7646
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2008
Last Update Date	:	06/02/2023

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