Organization
FERNANDO GONZALEZ VERGARA, M.D, P.A
Active
Other names
Innovative Health
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANA IVETTE GONZALEZ (MANAGER)
(786) 553-3391
Entity
Organization
Contact information
Practice address
8050 N UNIVERSITY DR, TAMARAC, FL 33321-2115
(786) 553-3391
(954) 998-7307
Mailing address
8050 N UNIVERSITY DR, TAMARAC, FL 33321-2115
(786) 553-3391
(954) 998-7307
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME114208
MEDICAL LICENCE
FL
Enumeration date
06/14/2016
Last updated
11/10/2022
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