Bryan Gonzalez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9118524 Issued in FL

Practice address

4765 SW 148TH Ave Ste 404
Davie, FL 33330-2128

Phone

(954) 374-7545

Fax

(954) 374-7543

NPI assigned

Jan 30, 2024

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Personalized Medicine Institute LLCGroup PAC ID 9436487725, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BHDECD/Endpoint/BHDECD

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.

• Personalized Medicine Institute, LLC.

  • Cardiovascular Disease Physician
  • Davie, FL
  • NPI 1376011551
  Medicare reassignment Care Compare group
• Kopa LLC

  • Multi-Specialty Clinic/Center
  • Orlando, FL
  • NPI 1417021114
  Medicare reassignment NPD

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1104688563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4765 SW 148TH AVE STE 404",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333302128",
            "telephone_number": "954-374-7545",
            "fax_number": "954-374-7543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4765 SW 148TH AVE STE 404",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333302128",
            "telephone_number": "954-374-7545",
            "fax_number": "954-374-7543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "BRYAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-30",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alessandra Josiane Gonzalez
• Alyssa Gonzalez
• Amanda Jean Gonzalez
• Amanda Michelle Gonzalez
• Aracelys Gonzalez
• Cesar Gonzalez, DDS, MS
• Daniel Gonzalez, M.D.
• Gerardo E Gonzalez
• Gianna Gonzalez
• Hector Joel Gonzalez II

• Physician Assistant in Davie, FL
• Providers in Davie, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.