Provider Demographics
NPI:1902416423
Name:GONZALEZ FERNANDEZ, ISABEL BEATRIZ
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:BEATRIZ
Last Name:GONZALEZ FERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3580 LAKE WORTH RD
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-4029
Mailing Address - Country:US
Mailing Address - Phone:561-425-5075
Mailing Address - Fax:561-360-3467
Practice Address - Street 1:3580 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-4029
Practice Address - Country:US
Practice Address - Phone:561-425-5075
Practice Address - Fax:561-360-3467
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11008376363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily