Provider Demographics
NPI:1871830588
Name:GONZALEZ, NANCY CAROL (ARNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:CAROL
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 1:11946 SW 54TH ST
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33330-4242
Mailing Address - Country:US
Mailing Address - Phone:954-434-4608
Mailing Address - Fax:954-680-1269
Practice Address - Street 1:11946 SW 54TH ST
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33330-4242
Practice Address - Country:US
Practice Address - Phone:954-434-4608
Practice Address - Fax:954-680-1269
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1429162163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics