Leopoldo B Gonzalez, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0022097 Issued in FL

Practice address

301 Health Park Blvd
Anderson Gibbs BLDG., Suite 221
St Augustine, FL 32086-5793

Phone

(904) 824-4277

Fax

(904) 824-4490

NPI assigned

Jul 12, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• James a Joyner III MD P a

  • Preferred Provider Organization
  • St Augustine, FL
  • NPI 1790086833
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231372800000",
    "number": "1154346153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HEALTH PARK BLVD",
            "address_2": "ANDERSON GIBBS BLDG., SUITE 221",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865793",
            "telephone_number": "904-824-4277",
            "fax_number": "904-824-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HEALTH PARK BLVD",
            "address_2": "ANDERSON GIBBS BLDG., SUITE 221",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865793",
            "telephone_number": "904-824-4277",
            "fax_number": "904-824-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "LEOPOLDO",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2009-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0022097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054187700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myragrace Japitana Golmayo, ARNP
• Eneida Gomez, MD
• Deanna Gonzalez Headen
• Erika Gonzalez Vazquez
• Clarissa Elizabeth Gonzalez
• Phillip Gonzalez
• Tamara Gonzalez, CCC-SLP
• Kenneth E Good, RPH
• Emoni Goodall
• Katelyn Goodall, PSY.D.

• Specialist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.