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Individual

PAUL J GONZALEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3531 LITTLE RD, TRINITY, FL 34655-1811
(727) 842-9900
(727) 844-5425
Mailing address
PO BOX 1527, ELFERS, FL 34680-1527
(727) 842-9900
(727) 844-5425

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME67843
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
066903200
FL
01
51220
BCBS INDIVIDUAL
FL
01
593371219
TAX ID
FL
01
74767
BCBS GROUP#
FL
01
DC7779
RAILROAD MEDICARE GROUP
FL
01
P00189718
RAILROAD MEDICARE INDIVID
FL
Enumeration date
10/25/2005
Last updated
03/18/2014
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