Provider Demographics
NPI:1265823330
Name:GONZALES, TONEY RUDOLFO (FNP)
Entity Type:Individual
Prefix:
First Name:TONEY
Middle Name:RUDOLFO
Last Name:GONZALES
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 30TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32968-7832
Mailing Address - Country:US
Mailing Address - Phone:865-296-4944
Mailing Address - Fax:
Practice Address - Street 1:2033 S PATRICK DR
Practice Address - Street 2:
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4418
Practice Address - Country:US
Practice Address - Phone:865-296-4944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-11
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008341363L00000X, 363LF0000X
FLAPRN9483373363LF0000X
TN0000018806363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner