Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | ME41667 | FL |
NPI | 1447324744 |
---|---|
Provider Name | Dr. Luis E Gonzalez-Mendoza |
First Address | Miami, FL 33155-3009 |
Second Address | Miami, FL 33155-3009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
043879100 | (05) | FL |
08449 | BLUE CROSSBLUESHIELD (01) | FL |
E-49846 | (02) | FL |