Individual
MR. JESUS MANUEL GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
206 PARK PLACE BLVD, KISSIMMEE, FL 34741-2344
(407) 846-0023
Mailing address
206 PARK PLACE BLVD, KISSIMMEE, FL 34741-2344
(407) 846-0023
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11022204
FL
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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