Provider Demographics
NPI:1891011805
Name:GONZALEZ, FELIX M (MD)
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:M
Last Name:GONZALEZ
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 1:4061 POWDER MILL RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CALVERTON
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3149
Mailing Address - Country:US
Mailing Address - Phone:202-669-8501
Mailing Address - Fax:240-846-1490
Practice Address - Street 1:59 EXECUTIVE PARK S
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2208
Practice Address - Country:US
Practice Address - Phone:404-778-6264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00716542085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology