Lidislay Gonzalez Fuentes, ARNP
Nurse Practitioner, Family in Hialeah, FL. Individual provider (NPI-1).
NPI number1801675673
StatusActive
Last updated in NPPESOct 11, 2024
Details
- NPI
- 1801675673
- Entity type
- Individual (NPI-1)
- Name
- Lidislay Gonzalez Fuentes
- Credential
- ARNP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 21, 2023
- Certification date
- Oct 11, 2024
- Last updated
- Oct 11, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | APRN11030508 | FL | Yes |
| 363LF0000X | Nurse Practitioner, Family | F09230547 | FL |
Practice location
1030 W 47th StHialeah, FL 33012-3317
Phone 786-531-8250
Mailing address
1030 W 47th StHialeah, FL 33012-3317
Phone 786-531-8250
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