Individual
MR. ALEXIS GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2301 S BROAD ST, 1ST FLOOR, PHILADELPHIA, PA 19148-3542
(215) 923-9323
(215) 952-1246
Mailing address
2301 S BROAD ST, 1ST FLOOR, PHILADELPHIA, PA 19148-3542
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN548175
PA
367H00000X
Anesthesiologist Assistant
26NR13112500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NR13112500
STATE LICENSE
NJ
Enumeration date
08/24/2009
Last updated
03/07/2014
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