Provider Demographics
NPI:1194582775
Name:GONZALEZ, MILENA (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:MILENA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12900 SW 117TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4617
Mailing Address - Country:US
Mailing Address - Phone:786-532-8151
Mailing Address - Fax:
Practice Address - Street 1:747 PONCE DE LEON BLVD STE 503
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2073
Practice Address - Country:US
Practice Address - Phone:305-529-9901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF02240969363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily