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General NPI Number Information
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NPI Number | 1790007607
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Entity Type | Individual
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Provider Name | MARCO AURELIO GONZALEZ MD
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Gender | Male
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Dates
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Enumeration Date | 02/18/2010
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE # S80
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City | CLEVELAND
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State | OH
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Zip | 44195-0002
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Country | US
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Telephone | 216-445-6501
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Fax | 216-636-2061
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Provider Business Mailing Address
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Address Line | 9500 EUCLID AVE # S80
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City | CLEVELAND
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State | OH
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Zip | 44195-0002
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Country | US
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Telephone | 216-445-6501
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Fax | 216-636-2061
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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 | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | 28076
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | 35.099947
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License Number State | OH
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