| Marisela Gonzalez M.D.P.A. | |
|
2780 Sw 87th Ave Suite 100 Miami FL 33165-3296 | |
| (305) 220-3700 | |
| (305) 220-9002 |
| Full Name | Marisela Gonzalez M.D.P.A. |
|---|---|
| Speciality | General Practice |
| Location | 2780 Sw 87th Ave, Miami, Florida |
| Authorized Official Name and Position | Marisela Gonzalez (PRESIDENT/SOLE PROPRIETOR) |
| Authorized Official Contact | 3052203700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marisela Gonzalez M.D.P.A. 2780 Sw 87th Ave Suite 100 Miami FL 33165-3296 Ph: (305) 220-3700 | Marisela Gonzalez M.D.P.A. 2780 Sw 87th Ave Suite 100 Miami FL 33165-3296 Ph: (305) 220-3700 |
| NPI Number | 1275836330 |
|---|---|
| Provider Enumeration Date | 12/13/2010 |
| Last Update Date | 12/13/2010 |
| Medicare PECOS PAC ID | 9739351024 |
|---|---|
| Medicare Enrollment ID | O20260529001531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275836330 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | ME59833 (Florida) | Primary |
| Provider Name | Marisela Gonzalez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1679500037 PECOS PAC ID: 0446239586 Enrollment ID: I20111010000484 |
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