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General NPI Number Information
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NPI Number | 1487496451
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Entity Type | Individual
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Provider Name | JOEL D GONZALEZ PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/11/2024
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 7100 W 20TH AVE STE G176
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City | HIALEAH
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State | FL
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Zip | 33016-1875
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Country | US
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Telephone | 786-475-1985
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Fax | 786-475-2854
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Provider Business Mailing Address
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Address Line | 2001 W 68TH ST
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City | HIALEAH
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State | FL
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Zip | 33016-1801
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Country | US
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Telephone | 786-860-6004
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Fax | 305-441-9342
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA9119315
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License Number State | FL
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