Provider Demographics
NPI:1548801319
Name:GONZALEZ, LIZETTE (APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:LIZETTE
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21140 SW 179TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-4200
Mailing Address - Country:US
Mailing Address - Phone:305-310-2807
Mailing Address - Fax:
Practice Address - Street 1:21140 SW 179TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33187-4200
Practice Address - Country:US
Practice Address - Phone:305-310-2807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003999363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily