Jose Raphael Gonzalez, PSY.D.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH13471 Issued in FL

Practice address

1848 SE 1St Ave
Fort Lauderdale, FL 33316-2875

Phone

(954) 885-9500

NPI assigned

Nov 19, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1104462647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SW 108TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653510",
            "telephone_number": "305-218-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1848 SE 1ST AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162875",
            "telephone_number": "954-885-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JOSE",
        "middle_name": "RAPHAEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH13471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Gonzalez, BCBA
• Jany Gonzalez, APRN
• Johnny Gonzalez, DMD
• Jorge Antonio Gonzalez Jr., M.D.
• Jose R. Gonzalez, MSW, LCSW
• Katelyn Gonzalez
• Melisa Gonzalez
• Miguel Angel Gonzalez, M.D.
• Nayeli Gonzalez
• Pedro Jose Gonzalez, M.D.

• Mental Health Counselor in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.