Active NPI
Kelly Gonzalez, N.P.
- Family Nurse Practitioner
- Venice, FL
National Provider Identifier
1609324201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN11008677
- Practice address
- 11814 Tempest Harbor Loop
Venice, FL 34292-3821 - Phone
- (401) 545-4039
- NPI assigned
- Sep 13, 2016
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN11008677 | FL | Primary |
Addresses
Primary practice location
11814 Tempest Harbor Loop
Venice, FL 34292-3821
Mailing address
11814 Tempest Harbor Loop
Venice, FL 34292-3821
Phone (401) 545-4039
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11008677 | FL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604534400000",
"number": "1609324201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11814 TEMPEST HARBOR LOOP",
"city": "VENICE",
"state": "FL",
"postal_code": "342923821",
"telephone_number": "401-545-4039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11814 TEMPEST HARBOR LOOP",
"city": "VENICE",
"state": "FL",
"postal_code": "342923821",
"telephone_number": "401-545-4039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "KELLY",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-13",
"last_updated": "2020-11-05",
"certification_date": "2020-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN11008677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Venice, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.