Provider Demographics
NPI:1609665967
Name:LEZCANO GONZALEZ, KADIR (APRN)
Entity type:Individual
Prefix:
First Name:KADIR
Middle Name:
Last Name:LEZCANO GONZALEZ
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 GROVE DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-1424
Mailing Address - Country:US
Mailing Address - Phone:239-234-9666
Mailing Address - Fax:
Practice Address - Street 1:975 GROVE DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-1424
Practice Address - Country:US
Practice Address - Phone:239-234-9666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-03
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11038796363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily