Healthcare Provider Details
I. General information
NPI: 1700874625
Provider Name (Legal Business Name): FELIX J GONZALEZ MD,P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/13/2005
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2510 SW 27TH AVE STE 101
MIAMI FL
33133-2164
US
IV. Provider business mailing address
PO BOX 557457
MIAMI FL
33255-7457
US
V. Phone/Fax
- Phone: 786-703-7000
- Fax: 786-703-7777
- Phone: 786-703-7000
- Fax: 786-703-7777
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | ME0044692 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: