Byron Oswaldo Mata Gonzalez
Family Doctor - Geriatric Medicine
175 W Pine Ave
Longwood
, Florida 32750
Byron Oswaldo Mata Gonzalez
Family Doctor - Geriatric Medicine
175 W Pine Ave
Longwood
, Florida 32750
(770) 718-1517
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About
Features
Specialties
- Family Doctor - Geriatric Medicine
Languages spoken
- English
Location
First Address
- Byron Oswaldo Mata Gonzalez
- 1631 Atlanta Hwy
- Gainesville, GA
- Zip : 30504-5942
- Phone : (770) 718-1517
Second Address
- Byron Oswaldo Mata Gonzalez
- 175 W Pine Ave
- Longwood, FL
- Zip : 32750
- Phone : (321) 363-6529
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207QG0300X | Family Doctor - Geriatric Medicine | 036-117456 | IL |
| Y | 207QG0300X | Family Doctor - Geriatric Medicine | 068243 | GA |
| N | 207QG0300X | Family Doctor - Geriatric Medicine | 29408 | AL |
National Provider Identifier
| NPI | 1326206897 |
|---|---|
| Provider Name | Byron Oswaldo Mata Gonzalez |
| First Address | Gainesville, GA 30504-5942 |
| Second Address | Longwood, FL 32750 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/05/2008 |
| Last Update Date | 26/11/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.