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General NPI Number Information
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NPI Number | 1629087614
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Entity Type | Organization
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Legal Business Name | C F GONZALEZ MD PA
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 7991 S SUNCOAST BLVD
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City | HOMOSASSA
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State | FL
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Zip | 34446
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Country | US
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Telephone | 352-382-8282
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Fax | 352-382-2289
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Provider Business Mailing Address
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Address Line | PO BOX 3749
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City | HOMOSASSA SPRINGS
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State | FL
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Zip | 34447
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Country | US
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Telephone | 352-382-8282
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Fax | 352-382-2289
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Authorized Official
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Title or Position | MD PRESIDENT
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Name | CARLOS F GONZALEZ
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Credential | MD
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Telephone | 352-382-8282
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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 |
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License Number State |
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