Active NPI
Yolangilicia Gonzalez, CERTIFIED PHLEBOTOMY
- Phlebotomy Technician
- Duluth, GA
National Provider Identifier
1053968826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- License
- 889104
- Practice address
- 3450 Breckinridge Blvd Apt 525
Duluth, GA 30096-7637 - Phone
- (256) 571-5762
- NPI assigned
- Aug 26, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | 889104 | GA | Primary |
Addresses
Primary practice location
3450 Breckinridge Blvd Apt 525
Duluth, GA 30096-7637
Mailing address
3450 Breckinridge Blvd Apt 525
Duluth, GA 30096-7637
Phone (256) 571-5762
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 889104 | GA | MD | Phlebotomy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566777600000",
"number": "1053968826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3450 BRECKINRIDGE BLVD APT 525",
"city": "DULUTH",
"state": "GA",
"postal_code": "300967637",
"telephone_number": "256-571-5762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3450 BRECKINRIDGE BLVD APT 525",
"city": "DULUTH",
"state": "GA",
"postal_code": "300967637",
"telephone_number": "256-571-5762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "YOLANGILICIA",
"name_prefix": "Ms.",
"credential": "CERTIFIED PHLEBOTOMY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-26",
"last_updated": "2019-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "GA",
"license": "889104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.