Provider Demographics
NPI:1821466475
Name:GONZALEZ & SONS HOME CARE,INC.
Entity Type:Organization
Organization Name:GONZALEZ & SONS HOME CARE,INC.
Other - Org Name:GONZALEZ & SONS HOME CARE II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LINO
Authorized Official - Middle Name:GILBERTO
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-317-4752
Mailing Address - Street 1:4290 SW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1924
Mailing Address - Country:US
Mailing Address - Phone:305-445-7880
Mailing Address - Fax:305-445-7880
Practice Address - Street 1:4290 SW 4TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1924
Practice Address - Country:US
Practice Address - Phone:305-445-7880
Practice Address - Fax:305-445-7880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL11241310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003808500Medicaid