Provider Demographics
NPI:1376260505
Name:GONZALEZ, ALEXANDRA EMILY RICH (MSN, ARPN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:EMILY RICH
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MSN, ARPN, FNP-BC
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:EMILY
Other - Last Name:RICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15600 SW 16TH CT
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-2348
Mailing Address - Country:US
Mailing Address - Phone:954-651-7331
Mailing Address - Fax:
Practice Address - Street 1:777 GLADES RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6496
Practice Address - Country:US
Practice Address - Phone:561-297-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11021853363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner