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NPI Code Detail

MEDICARE: FERNANDO CELSO GONZALEZ RODRIGUEZ P.A.

MEDICARE: FERNANDO CELSO GONZALEZ RODRIGUEZ P.A.
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
1363A00000XPhysician Assistant3047PR
2363AS0400XSurgical Physician Assistant3047PR
3246ZC0007XSurgical Assistant26-220FL
4363A00000XPhysician AssistantTPPA1241FL
5363AM0700XMedical Physician Assistant3047PR

General Provider Information

NPI Number : 1801732060
Entity Type Code : Individual
Provider Name (Legal Business Name) : FERNANDO CELSO GONZALEZ RODRIGUEZ P.A.
Provider Business Mailing Address
First Line : 3040 SW 11TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33135-4708
Country : US
Telephone Number : 305-502-7061
Fax Number :
Provider Business Practice Location Address
First Line : 865 E 10TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33010-4645
Country : US
Telephone Number : 305-502-7061
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2026
Last Update Date : 06/24/2026

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