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NPI Code Detail

MEDICARE: MR. EDUARDO A GONZALEZ MS, RD, LDN

MEDICARE: MR. EDUARDO A GONZALEZ MS, RD, LDN
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
1133V00000XRegistered Dietitian007759NY
2133V00000XRegistered DietitianND7605FL

General Provider Information

NPI Number : 1558709154
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDUARDO A GONZALEZ MS, RD, LDN
Provider Business Mailing Address
First Line : 7320 E FLETCHER AVE
Second Line :
City : TAMPA
State : FL
Zip : 33637-0916
Country : US
Telephone Number : 888-964-1975
Fax Number : 877-743-5351
Provider Business Practice Location Address
First Line : 7320 E FLETCHER AVE
Second Line :
City : TAMPA
State : FL
Zip : 33637-0916
Country : US
Telephone Number : 888-964-1975
Fax Number : 877-743-5351
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2013
Last Update Date : 07/20/2023

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