Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | APRN9359090 | FL |
N | 363LF0000X | Nurse Practitioner - Family Medicine | APRN9359090 | FL |
NPI | 1013386572 |
---|---|
Provider Name | Viviane L Goncalves |
First Address | Temple Terrace, FL 33637-0926 |
Second Address | Temple Terrace, FL 33637-0926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2015 |
Last Update Date | 28/10/2020 |