Provider Demographics
NPI:1245978345
Name:GONZALEZ VARELA, DONIS (AGPCNP)
Entity type:Individual
Prefix:
First Name:DONIS
Middle Name:
Last Name:GONZALEZ VARELA
Suffix:
Gender:M
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3640 NW 9TH ST APT 505
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3893
Mailing Address - Country:US
Mailing Address - Phone:786-525-8775
Mailing Address - Fax:
Practice Address - Street 1:3640 NW 9TH ST APT 505
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3893
Practice Address - Country:US
Practice Address - Phone:786-525-8775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11026799363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health