Provider Demographics
NPI:1235104555
Name:GONZALES, NORMAN MANAOIS (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:MANAOIS
Last Name:GONZALES
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 1:5320 PROVIDENCE RD STE 301
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-4122
Mailing Address - Country:US
Mailing Address - Phone:757-413-7600
Mailing Address - Fax:757-413-7601
Practice Address - Street 1:5320 PROVIDENCE RD STE 301
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4122
Practice Address - Country:US
Practice Address - Phone:757-413-7600
Practice Address - Fax:757-413-7601
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238194207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010185416Medicaid
VA010185416Medicaid
008267S33Medicare ID - Type Unspecified