Provider Demographics
NPI:1629126206
Name:GONZALEZ, ARIADNA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARIADNA
Middle Name:
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 1:9600 SW 8TH ST STE 16
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2947
Mailing Address - Country:US
Mailing Address - Phone:305-898-3226
Mailing Address - Fax:954-653-1450
Practice Address - Street 1:9600 SW 8TH ST STE 16
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174
Practice Address - Country:US
Practice Address - Phone:305-898-3226
Practice Address - Fax:954-653-1450
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 93085207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000395200Medicaid
FLAL923ZMedicare PIN