Individual
ALEX L GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4251 NW AMERICAN LN, STE 101, LAKE CITY, FL 32055-4881
(386) 758-6143
(386) 758-6046
Mailing address
4251 NW AMERICAN LN, STE 101, LAKE CITY, FL 32055-4881
(386) 438-8541
(386) 758-6046
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME61910
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15072
BCBS
—
05
—
266292200
—
FL
Enumeration date
08/02/2006
Last updated
09/16/2010
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