Active NPI
Mary-Ann Gonzalez
- Pharmacist
- North Fort Myers, FL
National Provider Identifier
1245726942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS57535
- Practice address
- 6391 Bayshore Rd
North Fort Myers, FL 33917-3130 - Phone
- (239) 543-5312
- NPI assigned
- Jul 5, 2018
- Last updated
- Jul 5, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS57535 | FL | Primary |
Addresses
Primary practice location
6391 Bayshore Rd
North Fort Myers, FL 33917-3130
Mailing address
3021 SW 92ND CT
Miami, FL 33165-3133
Phone (305) 790-0700
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 |
|---|---|---|---|
| PS57535 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS L.L.C. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530748800000",
"number": "1245726942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3021 SW 92ND CT",
"city": "MIAMI",
"state": "FL",
"postal_code": "331653133",
"telephone_number": "305-790-0700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6391 BAYSHORE RD",
"city": "NORTH FORT MYERS",
"state": "FL",
"postal_code": "339173130",
"telephone_number": "239-543-5312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "MARY-ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-05",
"last_updated": "2018-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS57535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.