Individual
JAVIER M GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
910 OLD CAMP RD, BLDG 210, THE VILLAGES, FL 32162-5604
(352) 751-3356
(352) 751-3359
Mailing address
308 W HIGHLAND BLVD, INVERNESS, FL 34452-4716
(352) 726-8353
(352) 726-5038
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME83005
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03015
BCBS OF FL
FL
01
—
0405694
CIGNA
DE
01
—
060065353
MEDICARE RR
FL
01
—
11319381
CAQH
FL
05
—
263252700
—
FL
01
—
269859500
MEDICAID GROUP
FL
01
—
77940
MEDICARE GROUP ID
FL
01
—
CF1416
MEDICARE RR GROUP
FL
01
—
ME83005
STATE LICENSE NUMBER
FL
Enumeration date
12/01/2005
Last updated
03/05/2013
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