Provider Demographics
NPI:1972125987
Name:GONZALEZ VIGOA, ANTONY (RN, ARNP)
Entity type:Individual
Prefix:
First Name:ANTONY
Middle Name:
Last Name:GONZALEZ VIGOA
Suffix:
Gender:M
Credentials:RN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17313 NW 63RD AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4470
Mailing Address - Country:US
Mailing Address - Phone:786-450-8270
Mailing Address - Fax:
Practice Address - Street 1:16795 NW 67TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4201
Practice Address - Country:US
Practice Address - Phone:305-913-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9512841163WG0000X
FLAPRN11028071363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice