Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN11004188 | FL |
N | 363LA2200X | Nurse Practitioner - Adult Health | APRN11004188 | FL |
N | 363LG0600X | Nurse Practitioner - Gerontology | APRN11004188 | FL |
N | 363LP2300X | Nurse Practitioner - Primary Care | APRN11004188 | FL |
NPI | 1053962589 |
---|---|
Provider Name | Septimio Julio Gonzalez Savournin |
First Address | Miami, FL 33128-1730 |
Second Address | Hialeah, FL 33012-3322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2019 |
Last Update Date | 10/12/2019 |