MEDICARE: FELIX I 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
1	207RG0100X	Gastroenterology Physician	ME44692	FL

General Provider Information

NPI Number	:	1922096304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FELIX I GONZALEZ MD PA

Provider Business Mailing Address
First Line	:	PO BOX 557457
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33255-7457
Country	:	US
Telephone Number	:	305-223-9938
Fax Number	:	305-554-8288

Provider Business Practice Location Address
First Line	:	3850 SW 87TH AVE
Second Line	:	STE 104
City	:	MIAMI
State	:	FL
Zip	:	33165-5400
Country	:	US
Telephone Number	:	305-223-9938
Fax Number	:	305-554-8288

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	MR. FELIX J GONZALEZ
Credential	:	MD
Telephone Number	:	305-223-9938

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	08/22/2020

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