MEDICARE: ANTHONY MICHAEL GONZALEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	ME0070563	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073588919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY MICHAEL GONZALEZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 198054
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-8054
Country	:	US
Telephone Number	:	305-271-9777
Fax Number	:

Provider Business Practice Location Address
First Line	:	8950 N KENDALL DR STE 601W
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-2139
Country	:	US
Telephone Number	:	305-271-9777
Fax Number	:	786-533-9518

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	09/20/2022

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