MEDICARE: DR. ESLER GONZALEZ OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPC6509	FL

General Provider Information

NPI Number	:	1073358479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ESLER GONZALEZ OD

Provider Business Mailing Address
First Line	:	310 SW 136TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33184-1022
Country	:	US
Telephone Number	:	786-332-9636
Fax Number	:

Provider Business Practice Location Address
First Line	:	13256 SW 8TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33184-1178
Country	:	US
Telephone Number	:	786-332-9636
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2024
Last Update Date	:	06/27/2024

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