Provider Demographics
NPI:1548572506
Name:GONZALEZ, DANEB (APRN)
Entity Type:Individual
Prefix:MRS
First Name:DANEB
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1695 NW 110TH AVE STE 317
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1930
Mailing Address - Country:US
Mailing Address - Phone:305-671-3654
Mailing Address - Fax:305-459-3242
Practice Address - Street 1:1695 NW 110TH AVE STE 317
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-1930
Practice Address - Country:US
Practice Address - Phone:305-671-3654
Practice Address - Fax:305-459-3242
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-07
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9191783363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics