| Jorge A Gonzalez Do Pa | |
|
4302 Alton Rd Suite 1020 Miami Beach FL 33140-2891 | |
| (305) 672-9333 | |
| (305) 672-9307 |
| Full Name | Jorge A Gonzalez Do Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 4302 Alton Rd, Miami Beach, Florida |
| Authorized Official Name and Position | Alexander Gonzalez (OFFICE MANAGER) |
| Authorized Official Contact | 3056729333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jorge A Gonzalez Do Pa 4302 Alton Rd Suite 1020 Miami Beach FL 33140-2891 Ph: (305) 672-9333 | Jorge A Gonzalez Do Pa 4302 Alton Rd Suite 1020 Miami Beach FL 33140-2891 Ph: (305) 672-9333 |
| NPI Number | 1578709382 |
|---|---|
| Provider Enumeration Date | 12/29/2008 |
| Last Update Date | 05/17/2022 |
| Medicare PECOS PAC ID | 7810054988 |
|---|---|
| Medicare Enrollment ID | O20090318000187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578709382 | NPI | - | NPPES |
| 036329400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS0004764 (Florida) | Primary |
| Provider Name | Jorge A Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205922135 PECOS PAC ID: 0042377111 Enrollment ID: I20090318000150 |
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