Individual
FERNANDO GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4175 W 20TH AVE, HIALEAH, FL 33012-5874
(305) 825-0300
Mailing address
3815 SW 82ND AVE APT 41, MIAMI, FL 33155-6716
(305) 267-3988
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME22761
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055314000
—
FL
Enumeration date
04/23/2007
Last updated
07/08/2007
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