Provider Demographics
NPI:1932777224
Name:GONZALEZ, ADRIAN FELIPE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:FELIPE
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13550 SW 88TH ST STE 112
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1539
Mailing Address - Country:US
Mailing Address - Phone:305-662-2590
Mailing Address - Fax:
Practice Address - Street 1:13550 SW 88TH ST STE 112
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1539
Practice Address - Country:US
Practice Address - Phone:305-662-2590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26693122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist