Provider Demographics
NPI:1568777415
Name:GONZALEZ, ALIRIO ALFONSO (ANP)
Entity Type:Individual
Prefix:MR
First Name:ALIRIO
Middle Name:ALFONSO
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2051
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:
Practice Address - Street 1:1208 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-4724
Practice Address - Country:US
Practice Address - Phone:954-583-0412
Practice Address - Fax:954-584-3906
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305521363LA2200X
FL9485015363LA2200X, 163WG0000X, 163WW0000X
NY533619-1163WG0000X, 163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WW0000XNursing Service ProvidersRegistered NurseWound Care