MEDICARE: PEDRO GONZALEZ GARCIA

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	104100000X	Social Worker
2	171M00000X	Case Manager/Care Coordinator

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346789252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEDRO GONZALEZ GARCIA

Provider Business Mailing Address
First Line	:	18901 NW 78TH PL
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-5285
Country	:	US
Telephone Number	:	786-222-4358
Fax Number	:

Provider Business Practice Location Address
First Line	:	18901 NW 78TH PL
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-5285
Country	:	US
Telephone Number	:	786-222-4358
Fax Number	:

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

Provider Enumeration Date	:	02/13/2017
Last Update Date	:	03/12/2024

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Directions to “ PEDRO GONZALEZ GARCIA ” Practice Location

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