Provider Demographics
NPI:1578578407
Name:ANA I GONZALEZ DO PA
Entity Type:Organization
Organization Name:ANA I GONZALEZ DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:I
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-299-9680
Mailing Address - Street 1:3564 CRYSTAL CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4036
Mailing Address - Country:US
Mailing Address - Phone:305-299-9680
Mailing Address - Fax:
Practice Address - Street 1:2000 S DIXIE HWY
Practice Address - Street 2:SUITE 104
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2456
Practice Address - Country:US
Practice Address - Phone:305-299-9680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS97002084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Not Answered2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty