Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 103792 | FL |
N | 2080P0202X | Pediatric Cardiologist | 27804 | SC |
NPI | 1134217458 |
---|---|
Provider Name | Dr. Javier Hernando Gonzalez |
First Address | Tampa, FL 33607 |
Second Address | Tampa, FL 33607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 18/06/2018 |