Provider Demographics
NPI:1871501981
Name:GONZALEZ-QUEVEDO, FELIX ARMANDO (PA-C)
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:ARMANDO
Last Name:GONZALEZ-QUEVEDO
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8940 SW 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-1708
Mailing Address - Country:US
Mailing Address - Phone:305-215-9033
Mailing Address - Fax:
Practice Address - Street 1:6550 N FEDERAL HWY
Practice Address - Street 2:SUITE 512
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1404
Practice Address - Country:US
Practice Address - Phone:954-267-8777
Practice Address - Fax:954-772-7801
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9100805363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2930137 00Medicaid
FLU1096YOtherMEDICARE PTAN
FL2930137 00Medicaid