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General NPI Number Information
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NPI Number | 1063206514
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Entity Type | Individual
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Provider Name | CRISTIAN ANTONIO GONZALEZ MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2025
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 1475 W 49TH PL
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City | HIALEAH
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State | FL
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Zip | 33012-3113
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Country | US
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Telephone | 813-690-1686
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Fax |
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Provider Business Mailing Address
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Address Line | 739 CRUISE VIEW DR
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City | TAMPA
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State | FL
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Zip | 33602-5916
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Country | US
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Telephone | 813-690-1686
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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