Misael Gonzalez Md P A | |
760 Ponce De Leon Blvd Ste 107a Coral Gables FL 33134-2076 | |
(305) 967-8311 | |
(305) 967-8506 |
Full Name | Misael Gonzalez Md P A |
---|---|
Speciality | General Practice |
Location | 760 Ponce De Leon Blvd Ste 107a, Coral Gables, Florida |
Authorized Official Name and Position | Misael Gonzalez (PRESIDENT) |
Authorized Official Contact | 3059678311 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Misael Gonzalez Md P A 760 Ponce De Leon Blvd, Suite 107a Coral Gables FL 33134-2076 Ph: (305) 967-8311 | Misael Gonzalez Md P A 760 Ponce De Leon Blvd Ste 107a Coral Gables FL 33134-2076 Ph: (305) 967-8311 |
NPI Number | 1932455904 |
---|---|
Provider Enumeration Date | 07/27/2012 |
Last Update Date | 10/21/2013 |
Medicare PECOS PAC ID | 0648427377 |
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Medicare Enrollment ID | O20120830000676 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932455904 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | ME80610 (Florida) | Primary |
Provider Name | Misael Gonzalez |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1922017813 PECOS PAC ID: 6709866106 Enrollment ID: I20040726000296 |
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