Individual
JOSE ANTONIO GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
13890 SW 143RD ST UNIT G, MIAMI, FL 33186-7556
(305) 753-5408
Mailing address
13890 SW 143RD ST UNIT G, MIAMI, FL 33186-7556
(305) 753-5408
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9113599
FL
363AM0700X
Medical Physician Assistant
Primary
PA9113599
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2019
Last updated
09/26/2022
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