Provider Demographics
NPI:1649619388
Name:CHAVEZ GONZALEZ, JOSE ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ALEXANDER
Last Name:CHAVEZ GONZALEZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:JOSE
Other - Middle Name:ALEXANDER
Other - Last Name:CHAVEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 100707
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-0707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3303 OVERSEAS HWY STE 100
Practice Address - Street 2:
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-2329
Practice Address - Country:US
Practice Address - Phone:305-434-1400
Practice Address - Fax:305-743-0962
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-16
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME151639207Q00000X
CAA133667207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine