Provider Demographics
NPI:1417731712
Name:GONZALEZ, DANIELA I (FNP)
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:I
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19566 E COUNTRY CLUB DR # 505
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-4830
Mailing Address - Country:US
Mailing Address - Phone:786-718-8509
Mailing Address - Fax:
Practice Address - Street 1:19655 E COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-4803
Practice Address - Country:US
Practice Address - Phone:786-718-8509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11027600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily