Organization
PATRICK M. GONZALEZ, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK M GONZALEZ M.D. (OWNERR)
(772) 873-1005
Entity
Organization
Contact information
Practice address
1420 SW SAINT LUCIE WEST BLVD, SUITE 102, PORT SAINT LUCIE, FL 34986-1709
(772) 873-1005
(772) 873-9106
Mailing address
1420 SW SAINT LUCIE WEST BLVD, SUITE 102, PORT SAINT LUCIE, FL 34986-1709
(772) 873-1005
(772) 873-9106
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME 67553
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377982300
—
FL
Enumeration date
08/10/2010
Last updated
08/10/2010
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