Organization
MIGUEL A GONZALEZ M.D. P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIGUEL ANGEL GONZALEZ M.D. (PRESIDENT)
(954) 523-8108
Entity
Organization
Contact information
Practice address
401 SE 16TH ST, FORT LAUDERDALE, FL 33316-2529
(954) 523-8108
(954) 525-9828
Mailing address
401 SE 16TH ST, FORT LAUDERDALE, FL 33316-2529
(954) 523-8108
(954) 525-9828
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
24288
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035917300
—
FL
Enumeration date
04/16/2012
Last updated
04/16/2012
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