Leopoldo B Gonzalez MD PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME0022097 Issued in FL

Legal business name

LEOPOLDO B GONZALEZ MD PA

Practice address

301 Health Park Blvd
Suite 323
St Augustine, FL 32086-5793

Phone

(904) 824-4277

Fax

(904) 824-4490

NPI assigned

Aug 14, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Leopoldo B Gonzalez, MDPA

Title

Owner

Phone

(904) 824-4277

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234915200000",
    "number": "1417103045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HEALTH PARK BLVD",
            "address_2": "SUITE 323",
            "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": "SUITE 323",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865793",
            "telephone_number": "904-824-4277",
            "fax_number": "904-824-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEOPOLDO B GONZALEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-14",
        "last_updated": "2009-02-18",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "LEOPOLDO",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-824-4277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MDPA"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME0022097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054187700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gloria J. Lelaidier, ARNP, CNMW
• Lending Hands of Inspiration
• Deborah Lennon, OTR/L
• Samantha Lentz
• Christopher Lenz, PHARMD
• Tammy J. Lesage, OTR/L, CHT
• Gabrielle Grace Leshane
• Heather Leshane, P.T.
• Karen Leslie
• Shannon T Leu, MD

• Surgery Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.