Individual
MR. FIDEL GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1201 NW 16TH ST, MIAMI, FL 33125-1624
(305) 324-4455
(305) 575-3161
Mailing address
4121 SW 141ST AVE, DAVIE, FL 33330-5723
(305) 324-4455
(305) 575-3161
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2112
FL
Other
Enumeration date
09/12/2006
Last updated
07/08/2007
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