Provider Demographics
NPI:1720635386
Name:GONZALEZ PEREZ, PAULA MARIA
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:MARIA
Last Name:GONZALEZ PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 PARK LN
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7554
Mailing Address - Country:US
Mailing Address - Phone:786-567-2561
Mailing Address - Fax:
Practice Address - Street 1:1217 S MILITARY TRL STE C
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-4600
Practice Address - Country:US
Practice Address - Phone:561-642-6309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-19
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11003765363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily