Active NPI
Max A Gonzalez, PHD
- Clinical Psychologist
- Miami, FL
National Provider Identifier
1104992239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY6082
- Practice address
- 1250 SW 27TH Ave
Ste 404
Miami, FL 33135 - Phone
- (305) 642-5255
- Fax
- (305) 642-8850
- NPI assigned
- Nov 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY6082 | FL | Primary |
Addresses
Primary practice location
1250 SW 27TH Ave
Ste 404
Miami, FL 33135
Mailing address
8953 SW 96TH St
Miami, FL 33176-2929
Phone (305) 642-5255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007219800 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY6082 | FL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luis Hines & Associates, PA | Clinical | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526428800000",
"number": "1104992239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8953 SW 96TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331762929",
"telephone_number": "305-642-5255",
"fax_number": "305-642-8850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 SW 27TH AVE",
"address_2": "STE 404",
"city": "MIAMI",
"state": "FL",
"postal_code": "33135",
"telephone_number": "305-642-5255",
"fax_number": "305-642-8850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "MAX",
"middle_name": "A",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2018-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY6082",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007219800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.