Provider Demographics
NPI:1396458709
Name:GONZALEZ, BIANCA ALEXA (APRN)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:ALEXA
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 1:5210 LINTON BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6537
Mailing Address - Country:US
Mailing Address - Phone:615-496-7900
Mailing Address - Fax:877-536-5811
Practice Address - Street 1:5210 LINTON BLVD STE 301
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6537
Practice Address - Country:US
Practice Address - Phone:561-496-7900
Practice Address - Fax:877-536-5811
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-30
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11023685363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty