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Individual

ISMAEL GONZALEZ RODRIGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PMHNP-BC

Contact information

Practice address
13000 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4745
(813) 972-2000
Mailing address
5038 BRICKWOOD RISE DR, WIMAUMA, FL 33598-4151
(813) 808-7762

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11026667
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APRN-11026667
FL

Other

Enumeration date
07/03/2023
Last updated
07/03/2023
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