Individual
JOSE M GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3601 FEDERAL HWY, MIAMI, FL 33137-3795
(305) 567-6611
(305) 576-0008
Mailing address
3601 FEDERAL HWY, MIAMI, FL 33137-3795
(305) 567-6611
(305) 576-0008
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME68684
FL
2084P0800X
Psychiatry Physician
Primary
ME68684
FL
2084P0805X
Geriatric Psychiatry Physician
ME68684
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27701S
MEDICARE
FL
05
—
379235800
—
FL
Enumeration date
07/27/2006
Last updated
11/17/2017
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