Provider Demographics
NPI:1306818323
Name:GONZALEZ, ORLANDO RUBEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ORLANDO
Middle Name:RUBEN
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:84 W JERSEY ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-4442
Mailing Address - Country:US
Mailing Address - Phone:407-422-1377
Mailing Address - Fax:407-422-1379
Practice Address - Street 1:84 W JERSEY ST
Practice Address - Street 2:SUITE 1
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-4442
Practice Address - Country:US
Practice Address - Phone:407-422-1377
Practice Address - Fax:407-422-1384
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0046140207ZB0001X, 207ZC0500X, 207ZD0900X, 207ZH0000X, 207ZI0100X, 207ZM0300X, 207ZN0500X, 207ZP0102X, 207ZP0104X, 207ZP0213X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No207ZI0100XAllopathic & Osteopathic PhysiciansPathologyImmunopathology
No207ZM0300XAllopathic & Osteopathic PhysiciansPathologyMedical Microbiology
No207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology
No207ZP0104XAllopathic & Osteopathic PhysiciansPathologyChemical Pathology
No207ZP0213XAllopathic & Osteopathic PhysiciansPathologyPediatric Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL061440800Medicaid
FL09353ZMedicare ID - Type Unspecified
FL061440800Medicaid