Provider Demographics
NPI:1891371191
Name:GONZALEZ, JANET KRISTY (APRN)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:KRISTY
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 SILKS RUN UNIT 1265
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2570
Mailing Address - Country:US
Mailing Address - Phone:305-517-3842
Mailing Address - Fax:
Practice Address - Street 1:600 SILKS RUN UNIT 1265
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2570
Practice Address - Country:US
Practice Address - Phone:305-517-3842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009782363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily