Provider Demographics
NPI:1558613000
Name:GONZALEZ AMARO, PEDRO (MD)
Entity Type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:
Last Name:GONZALEZ AMARO
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 1:1214 MARINER BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-5657
Mailing Address - Country:US
Mailing Address - Phone:352-277-5305
Mailing Address - Fax:352-616-0906
Practice Address - Street 1:50 NW 15TH ST STE 101
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4267
Practice Address - Country:US
Practice Address - Phone:786-886-1030
Practice Address - Fax:786-377-9629
Is Sole Proprietor?:No
Enumeration Date:2012-10-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME136597208D00000X, 208D00000X
PR12,990-I390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program