Healthcare Provider Details

I. General information

NPI: 1942029533
Provider Name (Legal Business Name): RAFAEL ANGEL GONZALEZ MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2024
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 SW 62ND AVE STE 600
SOUTH MIAMI FL
33143-4728
US

IV. Provider business mailing address

7000 SW 62ND AVE STE 600
SOUTH MIAMI FL
33143-4728
US

V. Phone/Fax

Practice location:
  • Phone: 305-228-4675
  • Fax: 305-702-9442
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAFAEL A GONZALEZ
Title or Position: PHYSICIAN
Credential: MD PA
Phone: 305-228-4675