Luis A Gonzalez, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME60685 Issued in FL

Practice address

270 N Sykes Creek Pkwy
Unit 108
Merritt Island, FL 32953

Phone

(321) 452-1061

Fax

(321) 453-0866

NPI assigned

May 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Atlantic Coast Pediatrics, M.D. P.a.

  • Pediatrics Physician
  • Merritt Island, FL
  • NPI 1609825694
  NPD (past) Authorized official

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1295793628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 541216",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329541216",
            "telephone_number": "321-450-1061",
            "fax_number": "321-453-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 N SYKES CREEK PKWY",
            "address_2": "UNIT 108",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "32953",
            "telephone_number": "321-452-1061",
            "fax_number": "321-453-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "LUIS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME60685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057773100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FL",
            "identifier": "17673",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Marie Goff, MSN, APRN, FNP-BC
• Stanley Golovac, MD
• Mary C Gonzalez Lizardo
• Hortencia Gonzalez
• Ivette H Gonzalez, O.D.
• Googly Eyes, Inc
• Grady L Goolsby, D.C.
• Victoria Faith Gough
• Holly Grafton-Watkins
• Vickie Gray

• Pediatrics Physician in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.