Provider Demographics
NPI:1073108973
Name:GONZALEZ PERERA, CHRISTOPHER LUIS (RN, BSN)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:LUIS
Last Name:GONZALEZ PERERA
Suffix:
Gender:M
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:557 W 45TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3862
Mailing Address - Country:US
Mailing Address - Phone:305-458-0848
Mailing Address - Fax:
Practice Address - Street 1:557 W 45TH PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3862
Practice Address - Country:US
Practice Address - Phone:305-458-0848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9547263163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherOTHER