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NPI Code Detail

MEDICARE: MANUEL D GONZALEZ MD PA

MEDICARE: MANUEL D GONZALEZ MD PA
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
1174400000XSpecialistME103534FL
2207R00000XInternal Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235453580
Entity Type Code : Organization
Provider Name (Legal Business Name) : MANUEL D GONZALEZ MD PA
Provider Business Mailing Address
First Line : 2141 NW 7TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33125-3483
Country : US
Telephone Number : 305-987-1007
Fax Number : 305-702-9442
Provider Business Practice Location Address
First Line : 2141 NW 7TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33125-3483
Country : US
Telephone Number : 305-987-1007
Fax Number : 305-702-9442
Authorized Official
Title or Position : MEDICAL DOCTOR
Name : DR. MANUEL D GONZALEZ
Credential : MD PA
Telephone Number : 305-987-1007
Provider Enumeration Date : 03/16/2010
Last Update Date : 12/27/2021

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Directions to “MANUEL D GONZALEZ MD PA ” Practice Location

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