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General NPI Number Information
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NPI Number | 1275792731
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Entity Type | Organization
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Legal Business Name | JOSE N GONZALEZ MD PA
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 11/08/2011
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Provider Practice Location Address
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Address Line | 1300 CORAL WAY SUITE 202
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City | MIAMI
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State | FL
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Zip | 33145-2934
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Country | US
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Telephone | 305-857-6980
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Fax | 305-857-6982
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Provider Business Mailing Address
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Address Line | 1300 CORAL WAY SUITE 202
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City | MIAMI
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State | FL
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Zip | 33145-2934
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Country | US
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Telephone | 305-857-6980
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Fax | 305-857-6982
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSE NOEL GONZALEZ
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Credential | M.D.
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Telephone | 305-857-6980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME0055652
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License Number State | FL
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