Individual
JAVIER GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
52 W UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 842-8475
(407) 849-6470
Mailing address
52 W UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 842-8475
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
OS16511
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107795600
—
FL
01
—
KF986
BCBS
FL
01
—
MX003
MEDICARE PTAN OHRI
FL
01
—
PS323
MEDICARE PTAN OHMG
FL
Enumeration date
04/30/2014
Last updated
03/27/2023
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