Individual
STEPHANIE NIKOLE GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18560 SW 52ND ST, MIRAMAR, FL 33029-6250
(954) 805-3533
Mailing address
18560 SW 52ND ST, MIRAMAR, FL 33029-6250
(954) 805-3533
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
PENDING
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9389804
FLORIDA STATE BOARD OF NURSING
FL
Enumeration date
07/11/2019
Last updated
07/11/2019
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