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General NPI Number Information
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NPI Number | 1558305458
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Entity Type | Individual
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Provider Name | EDUARDO JOAQUIN GONZALEZ MD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 07/22/2010
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Provider Practice Location Address
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Address Line | 8200 SW 117TH AVE SUITE # 114
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City | MIAMI
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State | FL
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Zip | 33183-3856
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Country | US
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Telephone | 305-271-5001
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Fax | 305-271-6779
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Provider Business Mailing Address
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Address Line | 8200 SW 117TH AVE SUITE # 114
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City | MIAMI
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State | FL
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Zip | 33183-3856
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Country | US
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Telephone | 305-271-5001
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Fax | 305-271-6779
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0039568
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License Number State | FL
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