Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 9772 | PR |
N | 208000000X | Pediatrician | 9772 | PR |
NPI | 1174582852 |
---|---|
Provider Name | Dr. Francisco Gonzalez |
First Address | Cutler Bay, FL 33190-1003 |
Second Address | Cutler Bay, FL 33190-1003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 27/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001160300 | (05) | FL |
ACN312 | LICENSE (01) | FL |