Provider Demographics
NPI:1033102447
Name:GONZALEZ, GABRIEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:E
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12959 PALMS WEST DRIVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470
Mailing Address - Country:US
Mailing Address - Phone:561-790-2258
Mailing Address - Fax:561-791-7489
Practice Address - Street 1:12959 PALMS WEST DRIVE
Practice Address - Street 2:SUITE 230
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-4940
Practice Address - Country:US
Practice Address - Phone:561-790-2258
Practice Address - Fax:561-791-7489
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL 0050008207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03679Medicare ID - Type Unspecified
D50789Medicare UPIN