Provider Demographics
NPI:1184687329
Name:GONZALEZ, EFRAIN H (MD)
Entity Type:Individual
Prefix:
First Name:EFRAIN
Middle Name:H
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 1:11020 SW 88TH ST STE 102C
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1217
Mailing Address - Country:US
Mailing Address - Phone:786-703-6120
Mailing Address - Fax:786-703-6108
Practice Address - Street 1:11020 SW 88TH ST STE 102C
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176
Practice Address - Country:US
Practice Address - Phone:786-703-6120
Practice Address - Fax:786-703-6108
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 57627207RC0000X
FLME57627207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009322000Medicaid
FLF39239Medicare UPIN
FL009322000Medicaid