Organization Active NPI

Glenda E Gonzalez M.D. PA

  • Internal Medicine Physician
  • Kissimmee, FL
National Provider Identifier
1407077878
Registry record updated Nov 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0076730 Issued in FL
Legal business name
GLENDA E GONZALEZ M.D. PA
Practice address
1000 E Osceola Pkwy
Kissimmee, FL 34744-1607
Phone
(407) 847-7910
Fax
(407) 932-2432
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2008

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

Authorized official

Name
Dr. Glenda E Gonzalez, M.D.
Title
President
Phone
(407) 856-5633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME0076730 FL Primary

Addresses

Primary practice location

1000 E Osceola Pkwy
Kissimmee, FL 34744-1607

Mailing address

1000 E Osceola Pkwy
Kissimmee, FL 34744-1607
Phone (407) 847-7910

Other identifiers 1

IdentifierTypeStateIssuer
267999000MedicaidFL

National Provider Directory

National Provider Directory

Locations

1000 E Osceola Pkwy
Kissimmee, FL 34744
Phone (407) 847-7910

12701 S John Young Pkwy
Ste 212
Orlando, FL 32837

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225756800000",
    "number": "1407077878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E OSCEOLA PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441607",
            "telephone_number": "407-847-7910",
            "fax_number": "407-932-2432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E OSCEOLA PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441607",
            "telephone_number": "407-847-7910",
            "fax_number": "407-932-2432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDA E GONZALEZ M.D. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2008-11-04",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-856-5633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0076730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267999000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; 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.