Individual
MICHELLE GONSALVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2675 WINKLER AVE FL 2FLOOR, FORT MYERS, FL 33901-9342
(855) 979-5700
Mailing address
2675 WINKLER AVE FL 2FLOOR, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
UO3068
FL
208M00000X
Hospitalist Physician
Primary
OS13272
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015038200
—
FL
01
—
1407S
BCBS FL
FL
Enumeration date
09/04/2013
Last updated
04/13/2022
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