Potenciano D Gonzales, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME70587 Issued in FL

Practice address

62 Spring Vista Dr Ste 100
Debary, FL 32713-1812

Phone

(386) 668-8559

Fax

(386) 668-8560

NPI assigned

Apr 1, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Inpatient Consultants of Florida, Inc

  • Internal Medicine Physician
  • Orange Park, FL
  • NPI 1396795597
  Medicare reassignment NPD
• Potenciano D Gonzales MD

  • Family Medicine Physician
  • Debary, FL
  • NPI 1336246073
  NPD (past) Authorized official
• Inpatient Consultants of Florida Inc

  • Hospitalist Physician
  • Tampa, FL
  • NPI 1457511164
  NPD
• Inpatient Consultants of Florida, Inc

  • Hospitalist Physician
  • Clearwater, FL
  • NPI 1811179831
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1043482813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 SPRING VISTA DR STE 101",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327131812",
            "telephone_number": "386-668-8559",
            "fax_number": "386-668-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 SPRING VISTA DR STE 100",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327131812",
            "telephone_number": "386-668-8559",
            "fax_number": "386-668-8560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "POTENCIANO",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-01",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME70587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251651900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander John Gargiso, DC
• Jennifer A Glaneman- Giagonelli, LMT
• Taylor Glasco, DC
• Timothy Glomb
• Elena Glusheska
• Stephanie Gonzales, DO
• Janelle Gonzalez, BCHHP
• Joni-Ann Gordon-Zahir
• Grace ,Natasha
• Grace and Harmony Inc

• Family Medicine Physician in Debary, FL
• Providers in Debary, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.