Provider Demographics
NPI:1639165319
Name:GONZALEZ, BRENDA
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 SW 92ND ST STE 204A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7377
Mailing Address - Country:US
Mailing Address - Phone:305-436-9933
Mailing Address - Fax:305-436-9944
Practice Address - Street 1:5000 UNIVERSITY DR STE 2200
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2008
Practice Address - Country:US
Practice Address - Phone:305-779-7381
Practice Address - Fax:305-779-7382
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67735207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263175000Medicaid
FLE3448ZMedicare ID - Type Unspecified
FL263175000Medicaid