Provider Demographics
NPI:1922096304
Name:FELIX I GONZALEZ MD PA
Entity Type:Organization
Organization Name:FELIX I GONZALEZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:J
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-223-9938
Mailing Address - Street 1:PO BOX 557457
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33255-7457
Mailing Address - Country:US
Mailing Address - Phone:305-223-9938
Mailing Address - Fax:305-554-8288
Practice Address - Street 1:3850 SW 87TH AVE
Practice Address - Street 2:STE 104
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-5400
Practice Address - Country:US
Practice Address - Phone:305-223-9938
Practice Address - Fax:305-554-8288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME44692207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty