Individual
BYRON OSWALDO MATA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1631 ATLANTA HWY, GAINESVILLE, GA 30504-5942
(770) 718-1517
Mailing address
1631 ATLANTA HWY, GAINESVILLE, GA 30504-5942
(770) 718-1517
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
036-117456
IL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
068243
GA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
29408
AL
208M00000X
Hospitalist Physician
Primary
ME139244
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102601800
—
FL
Enumeration date
05/30/2008
Last updated
04/28/2026
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