Active NPI
Jose Jorge Gonzalez Lavanderos
- Surgical Assistant
- Pompano Beach, FL
National Provider Identifier
1407494909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 17-302
- Practice address
- 6800 SW 18TH CT
Pompano Beach, FL 33068-4326 - Phone
- (954) 422-6500
- NPI assigned
- Dec 16, 2019
- 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 |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 17-302 | FL | Primary |
Addresses
Primary practice location
6800 SW 18TH CT
Pompano Beach, FL 33068-4326
Mailing address
6800 SW 18TH CT
Pompano Beach, FL 33068-4326
Phone (954) 422-6500
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17-302 | FL | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576454400000",
"number": "1407494909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 SW 18TH CT",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "330684326",
"telephone_number": "954-422-6500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 SW 18TH CT",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "330684326",
"telephone_number": "954-422-6500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ LAVANDEROS",
"first_name": "JOSE",
"middle_name": "JORGE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-12-16",
"last_updated": "2019-12-16",
"certification_date": "2019-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "FL",
"license": "17-302",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pompano Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.