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Individual

JUAN CARLOS GONZALEZ SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
6859 S EASTERN AVE STE 103, LAS VEGAS, NV 89119-0003
(702) 601-3771
Mailing address
6859 S EASTERN AVE STE 103, LAS VEGAS, NV 89119-0003
(702) 601-3771

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
823386
NV
363LF0000X
Family Nurse Practitioner
Primary
823386
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
250028288
NV
Enumeration date
05/26/2015
Last updated
03/26/2025
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