Provider Demographics
NPI:1891785994
Name:GONZALEZ-GOMEZ, ALBERTO (MD)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:
Last Name:GONZALEZ-GOMEZ
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 1:5200 SW 8TH ST
Mailing Address - Street 2:STE 204B
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2300
Mailing Address - Country:US
Mailing Address - Phone:305-445-9330
Mailing Address - Fax:305-448-6448
Practice Address - Street 1:5200 SW 8TH ST
Practice Address - Street 2:STE 204B
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2300
Practice Address - Country:US
Practice Address - Phone:305-445-9330
Practice Address - Fax:305-448-6448
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91892208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU4349ZMedicare PIN
FLK7283Medicare PIN
I26581Medicare UPIN