Individual
DR. NELSON GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11045 SW 216 ST, MIAMI, FL 33170
(786) 429-1639
(786) 883-0900
Mailing address
15753 SW 140TH ST, MIAMI, FL 33196-6714
(305) 431-6957
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME101417
FL
207QA0505X
Adult Medicine Physician
Primary
ME101417
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110070100
—
FL
Enumeration date
09/18/2007
Last updated
12/13/2022
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