Provider Demographics
NPI:1205223203
Name:GONZALEZ, ARTURO
Entity Type:Individual
Prefix:
First Name:ARTURO
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8813 PINTO DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-1189
Mailing Address - Country:US
Mailing Address - Phone:561-880-0123
Mailing Address - Fax:
Practice Address - Street 1:8813 PINTO DR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-1189
Practice Address - Country:US
Practice Address - Phone:561-880-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL242T00000X, 246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist