Healthcare Provider Details
I. General information
NPI: 1689080236
Provider Name (Legal Business Name): GIAN PAOLO GIULIARI GONZALEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/03/2014
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4676 DOUGLAS CIR NW
CANTON OH
44718-3619
US
IV. Provider business mailing address
5505 PEACHTREE DUNWOODY RD STE 300
ATLANTA GA
30342-1713
US
V. Phone/Fax
- Phone: 330-494-1116
- Fax:
- Phone: 404-257-0814
- Fax: 404-843-8521
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | 35.134506 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | 92227 |
| License Number State | GA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | MD491035 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: