Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | 0426273 | KS |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 0426273 | KS |
NPI | 1376524298 |
---|---|
Provider Name | Dr. Federico Gonzalez |
First Address | Olathe, KS 66061-3139 |
Second Address | Lenexa, KS 66227-6201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 06/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04-26273 | KANSAS LICENSE (01) | KS |
100141250C | (05) | KS |
1300066 | UHC (01) | KS |
18975138 | BLUE CROSS (01) | KS |
4346992 | AETNA (01) | |
B74810 | (02) |