MEDICARE: ARIEL GONZALES MD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	ME176065	FL
3	207Q00000X	Family Medicine Physician	0101286577	VA

General Provider Information

NPI Number	:	1477295541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIEL GONZALES MD

Provider Business Mailing Address
First Line	:	8333 NW 53RD ST FL 6
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33166-4783
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3448 NW 79TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33147-4602
Country	:	US
Telephone Number	:	786-949-6347
Fax Number	:	866-285-7068

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

Provider Enumeration Date	:	04/10/2022
Last Update Date	:	06/01/2026

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Directions to “ ARIEL GONZALES MD” Practice Location

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