Provider Demographics
NPI:1821573445
Name:GONZALEZ, PIERRE ANTONIO (AGPCNP-BC)
Entity Type:Individual
Prefix:MR
First Name:PIERRE
Middle Name:ANTONIO
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 610263
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33261-0263
Mailing Address - Country:US
Mailing Address - Phone:786-877-9604
Mailing Address - Fax:305-503-9398
Practice Address - Street 1:13350 N MIAMI AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-4715
Practice Address - Country:US
Practice Address - Phone:786-877-9604
Practice Address - Fax:305-503-9398
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9394291363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care