Provider Demographics
NPI:1912149014
Name:FRANCISCO H GONZALEZ MDPA
Entity Type:Organization
Organization Name:FRANCISCO H GONZALEZ MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:H
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-642-1895
Mailing Address - Street 1:19918 SW 7TH PL
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-1256
Mailing Address - Country:US
Mailing Address - Phone:305-642-1895
Mailing Address - Fax:786-621-0334
Practice Address - Street 1:1250 SW 27TH AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4741
Practice Address - Country:US
Practice Address - Phone:305-642-1895
Practice Address - Fax:786-621-0334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-03
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZME0028574208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252404000Medicaid
FLBO911AMedicare PIN
FL32883BMedicare PIN
FL252404000Medicaid