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General NPI Number Information
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NPI Number | 1407157324
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Entity Type | Organization
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Legal Business Name | NELSON L GONZALEZ DPM PA
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Dates
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Enumeration Date | 11/09/2010
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 2500 DEL PRADO BLVD S
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City | CAPE CORAL
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State | FL
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Zip | 33904-5750
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Country | US
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Telephone | 239-541-1095
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Fax | 239-542-1095
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Provider Business Mailing Address
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Address Line | 16200 NW 84TH CT
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City | MIAMI LAKES
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State | FL
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Zip | 33016-6672
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Country | US
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Telephone | 786-543-3464
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Fax | 786-558-9845
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NELSON L GONZALEZ
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Credential | DPM
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Telephone | 239-541-1095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO3291
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License Number State | FL
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