Provider Demographics
NPI:1467954693
Name:GONZALEZ ORDONEZ, HECTOR MARIO
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:MARIO
Last Name:GONZALEZ ORDONEZ
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 1:12426 BLACKSMITH DR APT 207
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-3401
Mailing Address - Country:US
Mailing Address - Phone:407-967-7445
Mailing Address - Fax:
Practice Address - Street 1:7550 FUTURES DR STE 105
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-9096
Practice Address - Country:US
Practice Address - Phone:407-730-7983
Practice Address - Fax:844-743-6224
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-04
Last Update Date:2018-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator