Individual provider Active NPI

Giovanni A Gonzalez

  • General Practice Dentistry
  • Miami, FL
National Provider Identifier
1417436189
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23529 Issued in FL
Practice address
8300 W Flagler St Ste 210
Miami, FL 33144-6002
Phone
(786) 501-2163
NPI assigned
Aug 13, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 23529 FL Primary

Addresses

Primary practice location

8300 W Flagler St Ste 210
Miami, FL 33144-6002

Mailing address

1451 Coruna Ave
Coral Gables, FL 33156-6315

Other practice location 1

1507 N John Young Pkwy
Kissimmee, FL 34741-3214
Phone (407) 606-8012

Other practice location 2

1 Glen Royal Pkwy
Miami, FL 33125-5287
Phone (305) 847-9915

Other practice location 3

807 S Parsons Ave
Brandon, FL 33511-6063
Phone (813) 527-0245

Other identifiers 1

IdentifierTypeStateIssuer
DN23529OtherFLDN LICENSE

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

LicenseStateTypeSpecialty
23529FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Flossy Dental of Hollywood Current Accepting new patients
Mobile Smiles LLC Current Accepting new patients

Locations

3220 Stirling Rd
Fl 2
Hollywood, FL 33021

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1417436189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 CORUNA AVE",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331566315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 W FLAGLER ST STE 210",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331446002",
            "telephone_number": "786-501-2163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1507 N John Young Pkwy",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347413214",
            "country_code": "US",
            "telephone_number": "407-606-8012",
            "fax_number": "954-953-1417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Glen Royal Pkwy",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331255287",
            "country_code": "US",
            "telephone_number": "305-847-9915",
            "fax_number": "954-953-1417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "807 S Parsons Ave",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335116063",
            "country_code": "US",
            "telephone_number": "813-527-0245",
            "fax_number": "954-953-1417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "GIOVANNI",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-13",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "23529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DN LICENSE",
            "identifier": "DN23529",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.