Provider Demographics
NPI:1639174709
Name:POSADA, ROBERTO GONZALES (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:GONZALES
Last Name:POSADA
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 1:1181 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4907
Mailing Address - Country:US
Mailing Address - Phone:407-647-1331
Mailing Address - Fax:407-571-2757
Practice Address - Street 1:1181 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4907
Practice Address - Country:US
Practice Address - Phone:407-647-1331
Practice Address - Fax:407-571-2757
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL61127174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370313400Medicaid
FL020037001OtherPALMETTO GBA - RAILROAD MEDICARE
FL020037001OtherPALMETTO GBA - RAILROAD MEDICARE
FL370313400Medicaid