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NPI Code Detail

MEDICARE: DR. YANEY GONZALEZ D.M.D

MEDICARE: DR. YANEY GONZALEZ D.M.D
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
1122300000XDentistDN17900FL

General Provider Information

NPI Number : 1457593840
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YANEY GONZALEZ D.M.D
Provider Business Mailing Address
First Line : 9340 W FLAGLER ST
Second Line : SUITE 102
City : MIAMI
State : FL
Zip : 33174-3440
Country : US
Telephone Number : 786-281-8177
Fax Number :
Provider Business Practice Location Address
First Line : 7030 NORMANDY BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32205-6206
Country : US
Telephone Number : 904-786-5850
Fax Number : 904-786-3101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2009
Last Update Date : 11/07/2012

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