Healthcare Provider Details

I. General information

NPI: 1669859468
Provider Name (Legal Business Name): UVALDO GONZALEZ P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2015
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 SW 8TH ST STE 202
MIAMI FL
33144-4400
US

IV. Provider business mailing address

1690 SW 69TH AVE
MIAMI FL
33155-1743
US

V. Phone/Fax

Practice location:
  • Phone: 786-558-9009
  • Fax:
Mailing address:
  • Phone: 305-218-1628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3046
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number15-308
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberTPPA1240
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number3046
License Number StatePR
# 5
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number3046
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: