Gonzalo Huaman, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME11457 Issued in FL

Practice address

1403 Medical Plaza Dr
Suite 101
Sanford, FL 32771-1000

Phone

(407) 322-0090

Fax

(407) 321-3783

NPI assigned

Oct 11, 2005

Reactivated

Feb 8, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• The Urology Center

  • Urology Physician
  • Sanford, FL
  • NPI 1477918415
  NPD (past) Authorized official

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1477541720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 MEDICAL PLAZA DR",
            "address_2": "SUITE 101",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711000",
            "telephone_number": "407-322-0090",
            "fax_number": "407-321-3783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 MEDICAL PLAZA DR",
            "address_2": "SUITE 101",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711000",
            "telephone_number": "407-322-0090",
            "fax_number": "407-321-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUAMAN",
        "first_name": "GONZALO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2018-02-08",
        "deactivation_date": "2018-01-11",
        "reactivation_date": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME11457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045559800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Horizon Health Management & Consulting Group of Florida
• Horizon Medical Clinic, LLC
• Allison Renee Hornback, L.C.S.W.
• Gayle S Hornung, RN BSN
• Geneva Howard, M.S.
• Thara L Hudson
• Charles Robert Hufham, PTA
• Shelley Hughes, RT
• Hughston Clinic Southeast PC
• Ahla Husain, PA

• Urology Physician in Sanford, FL
• Providers in Sanford, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.