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General NPI Number Information
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NPI Number | 1164649786
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Entity Type | Individual
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Provider Name | FLORENCIO JORGE GONZALEZ MD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3100 CLAY AVE SUITE # 299
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City | ORLANDO
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State | FL
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Zip | 32804-4026
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Country | US
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Telephone | 407-447-1628
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Fax |
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Provider Business Mailing Address
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Address Line | 3100 CLAY AVE STE 299
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City | ORLANDO
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State | FL
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Zip | 32804-4020
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Country | US
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Telephone | 407-447-1628
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | ME79378
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License Number State | FL
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