Healthcare Provider Details

I. General information

NPI: 1336331271
Provider Name (Legal Business Name): JULIO GONZALEZ-PAOLI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4012 N FLORIDA AVE
TAMPA FL
33603-3816
US

IV. Provider business mailing address

38135 MARKET SQ
ZEPHYRHILLS FL
33542-7505
US

V. Phone/Fax

Practice location:
  • Phone: 813-782-1234
  • Fax: 813-355-5066
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberME107120
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: