Provider Demographics
NPI:1205504008
Name:LEE GONZALEZ, HAIZEA (DNP, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:HAIZEA
Middle Name:
Last Name:LEE GONZALEZ
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:DR
Other - First Name:HAIZEA
Other - Middle Name:
Other - Last Name:LULICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP, FNP-BC
Mailing Address - Street 1:8701 N US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-7524
Mailing Address - Country:US
Mailing Address - Phone:772-228-8480
Mailing Address - Fax:
Practice Address - Street 1:8701 N US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-7524
Practice Address - Country:US
Practice Address - Phone:772-228-8480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-06
Last Update Date:2021-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11013171363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily