Provider Demographics
NPI:1598718785
Name:GONZALEZ, ANA ISABEL (MD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:ISABEL
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 CORAL WAY
Mailing Address - Street 2:SUITE 307
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:305-444-7733
Mailing Address - Fax:305-444-7150
Practice Address - Street 1:401 CORAL WAY
Practice Address - Street 2:SUITE 307
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134
Practice Address - Country:US
Practice Address - Phone:305-444-7733
Practice Address - Fax:305-444-7150
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL0049708207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL055887700Medicaid
F24372Medicare UPIN
14884Medicare ID - Type Unspecified