Individual
KENNY GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14000 FIVAY RD, HUDSON, FL 34667-7103
(727) 819-2929
Mailing address
8205 PRAISE DR, TAMPA, FL 33625-3701
(727) 564-2656
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
11017987
FL
Other
Enumeration date
03/14/2022
Last updated
03/14/2022
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