Individual
JACKELINE GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4013 SW 144TH PL, MIAMI, FL 33175-7844
(786) 246-3719
Mailing address
4013 SW 144TH PL, MIAMI, FL 33175-7844
(786) 246-3719
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9285295
FL
Other
Enumeration date
09/17/2018
Last updated
09/17/2018
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