MEDICARE: MEDICAL INTERVENTIONS OF CENTRAL FLORIDA, INC.

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	207R00000X	Internal Medicine Physician		FL

General Provider Information

NPI Number	:	1225036460
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL INTERVENTIONS OF CENTRAL FLORIDA, INC.

Provider Business Mailing Address
First Line	:	265 W HWY 50
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-3027
Country	:	US
Telephone Number	:	352-394-5535
Fax Number	:	352-394-5810

Provider Business Practice Location Address
First Line	:	265 W HWY 50
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-3027
Country	:	US
Telephone Number	:	352-394-5535
Fax Number	:	352-394-5810

Authorized Official
Title or Position	:	OWNER / PRESIDENT
Name	:	DR. JAIME C GONZALEZ
Credential	:	M.D.
Telephone Number	:	352-394-5535

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/21/2022

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