Potenciano Gonzales MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

POTENCIANO GONZALES MD PA

Practice address

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

Phone

(386) 668-8559

NPI assigned

Jan 29, 2010

Last updated

Sep 30, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Potenciano Divino Gonzales Jr., MDNPI 1043482813

Title

Physician

Phone

(386) 668-8559

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Potenciano D Gonzales, MD

  • Family Medicine Physician
  • Debary, FL
  • NPI 1043482813
  Authorized official Same address or phone

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285804800000",
    "number": "1043541162",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTENCIANO GONZALES MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-29",
        "last_updated": "2010-09-30",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "POTENCIANO",
        "authorized_official_middle_name": "DIVINO",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "386-668-8559",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Cathleen Perun, MA, LMHC
• Physical Medicine Center of Debary (Central Florida Pain Management Centers, LLC)
• Nathan Richard Pirino
• Podiatry Plus, LLC
• Potenciano D Gonzales MD
• Premier Physician Associates, P.a. (NextHealth Care)
• Jelicia Pringle, DC
• Pronto One Pharmacy, LLC
• Shanay Sharee Pugh
• Elizabeth M Quintavalle

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.