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NPI Code Detail

MEDICARE: DR. PAMELA LIZZIE GONZALEZ MD

MEDICARE: DR. PAMELA LIZZIE GONZALEZ 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
1390200000XStudent in an Organized Health Care Education/Training Program
2207R00000XInternal Medicine PhysicianME175780FL

General Provider Information

NPI Number : 1891497145
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAMELA LIZZIE GONZALEZ MD
Provider Business Mailing Address
First Line : 1580 SANTA BARBARA BLVD
Second Line :
City : THE VILLAGES
State : FL
Zip : 32159-6827
Country : US
Telephone Number : 352-259-2159
Fax Number : 352-259-5731
Provider Business Practice Location Address
First Line : 1580 SANTA BARBARA BLVD
Second Line :
City : THE VILLAGES
State : FL
Zip : 32159-6827
Country : US
Telephone Number : 352-259-2159
Fax Number : 352-259-5731
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2023
Last Update Date : 06/02/2026

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