Marisela Gonzalez M.D.P.a.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME59833 Issued in FL

Legal business name

MARISELA GONZALEZ M.D.P.A.

Practice address

2780 SW 87TH Ave
Suite 100
Miami, FL 33165-3296

Phone

(305) 220-3700

Fax

(305) 220-9002

NPI assigned

Dec 13, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Marisela Gonzalez, M.D.NPI 1679500037

Title

President/Sole Proprietor

Phone

(305) 220-3700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marisela Gonzalez, M.D.

  • General Practice Physician
  • Miami, FL
  • NPI 1679500037
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292198400000",
    "number": "1275836330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 SW 87TH AVE",
            "address_2": "SUITE 100",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653296",
            "telephone_number": "305-220-3700",
            "fax_number": "305-220-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 SW 87TH AVE",
            "address_2": "SUITE 100",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653296",
            "telephone_number": "305-220-3700",
            "fax_number": "305-220-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARISELA GONZALEZ M.D.P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-13",
        "last_updated": "2010-12-13",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "MARISELA",
        "authorized_official_title_or_position": "PRESIDENT/SOLE PROPRIETOR",
        "authorized_official_telephone_number": "305-220-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME59833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Miami, FL
• Providers in Miami, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.