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General NPI Number Information
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NPI Number | 1336672716
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Entity Type | Individual
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Provider Name | DANIEL GONZALEZ
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Gender | Male
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Dates
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Enumeration Date | 04/04/2017
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 4665 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33146-2101
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Country | US
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Telephone | 786-464-0749
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Fax |
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Provider Business Mailing Address
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Address Line | 2148 W 54TH ST
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City | HIALEAH
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State | FL
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Zip | 33016-2032
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Country | US
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Telephone |
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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 | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | A186364
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | 6061870
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | ME153559
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | 349189
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License Number State | LA
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