Provider Demographics
NPI:1851168348
Name:GONZALEZSALMERON, CONSUELO (RN)
Entity Type:Individual
Prefix:
First Name:CONSUELO
Middle Name:
Last Name:GONZALEZSALMERON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11315 JOHNS CREEK PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-2647
Mailing Address - Country:US
Mailing Address - Phone:786-892-7820
Mailing Address - Fax:
Practice Address - Street 1:11315 JOHNS CREEK PKWY STE 440
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-2648
Practice Address - Country:US
Practice Address - Phone:678-892-7820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN277926208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery