Individual
DR. GONZALO G VALDIVIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1421 MALABAR RD NE, STE 200, PALM BAY, FL 32907-2576
(321) 308-2660
(321) 984-9303
Mailing address
650 S COURTENAY PKWY, SUITE 200, MERRITT ISLAND, FL 32952-4977
(321) 394-2660
(321) 394-2669
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME81813
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114495500
—
FL
01
—
P00037101
MEDICARE RAILROAD
FL
Enumeration date
02/16/2006
Last updated
08/19/2022
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