Provider Demographics
NPI:1548791643
Name:CARMONA GONZALEZ, DANIA (MSN, FNP)
Entity Type:Individual
Prefix:
First Name:DANIA
Middle Name:
Last Name:CARMONA GONZALEZ
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8650 NW 97TH AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2575
Mailing Address - Country:US
Mailing Address - Phone:786-301-8948
Mailing Address - Fax:
Practice Address - Street 1:8650 NW 97TH AVE APT 102
Practice Address - Street 2:
Practice Address - City:MEDLEY
Practice Address - State:FL
Practice Address - Zip Code:33178-2575
Practice Address - Country:US
Practice Address - Phone:786-301-8948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9328641363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily