Provider Demographics
NPI:1588191308
Name:GONZALEZ, ADRIANA LISA (ARNP)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:LISA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16281 SW 68TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-4402
Mailing Address - Country:US
Mailing Address - Phone:305-898-0849
Mailing Address - Fax:
Practice Address - Street 1:11430 N KENDALL DR STE D309
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1032
Practice Address - Country:US
Practice Address - Phone:305-898-0849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9191714363L00000X
FLAPRN9191714363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN9191714OtherMEDICAL LICENSE