# FANNY GONZALEZ, M.D. P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144547399
- **Authorized official:** DR. FANNY GONZALEZ M.D. (OWNER)
- **Authorized official phone:** (305) 856-7005

## Contact information

- **Practice address:** 2525 SW 3RD AVE, UNIT CU1, MIAMI, FL 33129-2056
- **Practice address phone:** (305) 856-7005
- **Practice address fax:** (305) 856-7533
- **Mailing address:** PO BOX 144653, CORAL GABLES, FL 33114-4653

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0210X | Pediatric Nephrology Physician | ME106001 | FL | Yes |

## Other

- **Enumeration date:** 04/28/2010
- **Last updated:** 05/10/2012