Provider Demographics
NPI:1114239399
Name:GONZALEZ, JAVIER IGNACIO (MD)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:IGNACIO
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7727 LAKE UNDERHILL RD
Mailing Address - Street 2:DEPT. OF EMERGENCY MEDICINE
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8224
Mailing Address - Country:US
Mailing Address - Phone:407-303-6413
Mailing Address - Fax:407-303-6414
Practice Address - Street 1:7727 LAKE UNDERHILL RD
Practice Address - Street 2:DEPT. OF EMERGENCY MEDICINE
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8224
Practice Address - Country:US
Practice Address - Phone:407-303-6413
Practice Address - Fax:407-303-6414
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-05
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME107827207P00000X
NY255897207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine