Provider Demographics
NPI:1679968572
Name:GONZALEZ, ANDREAS (MD)
Entity Type:Individual
Prefix:
First Name:ANDREAS
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ANDRES
Other - Middle Name:
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6561 E CARONDELET DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2156
Mailing Address - Country:US
Mailing Address - Phone:520-886-2597
Mailing Address - Fax:520-886-6639
Practice Address - Street 1:6561 E CARONDELET DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2156
Practice Address - Country:US
Practice Address - Phone:520-886-2597
Practice Address - Fax:520-886-6639
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ62571207W00000X
CAA162647207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology