| Gonzales Corporation | |
|
12208 Mirandy Ct Ne Albuquerque NM 87122-1274 | |
| (505) 554-4579 | |
| Not Available |
| Full Name | Gonzales Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 12208 Mirandy Ct Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | James Orlando Gonzales (MANAGING MEMBER) |
| Authorized Official Contact | 5055544579 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gonzales Corporation 12208 Mirandy Ct Ne Albuquerque NM 87122-1274 Ph: (505) 554-4579 | Gonzales Corporation 12208 Mirandy Ct Ne Albuquerque NM 87122-1274 Ph: (505) 554-4579 |
| NPI Number | 1497516546 |
|---|---|
| Provider Enumeration Date | 01/17/2024 |
| Last Update Date | 05/07/2024 |
| Medicare PECOS PAC ID | 8123461944 |
|---|---|
| Medicare Enrollment ID | O20240208003259 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497516546 | NPI | - | NPPES |
| Provider Name | James Gonzales |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730507955 PECOS PAC ID: 3476850116 Enrollment ID: I20170405002161 |
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