MEDICARE: DR. JOSE NOEL 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	207Q00000X	Family Medicine Physician	55652	FL
2	207Q00000X	Family Medicine Physician	ME0055652	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	:	1679536189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE NOEL GONZALEZ M.D.

Provider Business Mailing Address
First Line	:	5040 NW 7TH ST STE 530
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3432
Country	:	US
Telephone Number	:	305-995-0140
Fax Number	:	305-995-0144

Provider Business Practice Location Address
First Line	:	5040 NW 7TH ST STE 530
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3432
Country	:	US
Telephone Number	:	305-995-0141
Fax Number	:	305-995-0144

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

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	02/29/2024

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