Individual
ELISE NANCY GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2627 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4717
(904) 308-7372
Mailing address
2627 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4717
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS22871
FL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
UO10090
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/25/2024
Last updated
04/02/2026
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