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Organization
PRIMARY HEALTHCARE
Active
Organization
PRIMARY HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGIA FAE GONZALEZ FNP (OWNER/MANAGER)
(352) 857-4493
Entity
Organization
Contact information
Practice address
19990 NW 13TH ST, DUNNELLON, FL 34431-1504
(352) 857-4493
Mailing address
19990 NW 13TH ST, DUNNELLON, FL 34431-1504
(352) 857-4493
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/28/2021
Last updated
01/28/2021
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