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NPI Code Detail

MEDICARE: ANGELA GONZALEZ MD

MEDICARE: ANGELA GONZALEZ MD
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
1207V00000XObstetrics & Gynecology PhysicianME120125FL

General Provider Information

NPI Number : 1861719981
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA GONZALEZ MD
Provider Business Mailing Address
First Line : PO BOX 748817
Second Line :
City : ATLANTA
State : GA
Zip : 30374-8817
Country : US
Telephone Number : 813-286-0033
Fax Number : 813-282-1806
Provider Business Practice Location Address
First Line : 948 CYPRESS VILLAGE BLVD STE A
Second Line :
City : RUSKIN
State : FL
Zip : 33573-6841
Country : US
Telephone Number : 813-633-3002
Fax Number : 813-633-6392
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2010
Last Update Date : 06/23/2023

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Directions to “ ANGELA GONZALEZ MD” Practice Location

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