Individual provider Active NPI

Gonzalo Gonzalez, M.D.

  • Internal Medicine Physician
  • Lake Worth, FL
National Provider Identifier
1477621373
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME99529 Issued in FL
Practice address
2531 N Dixie Hwy
Lake Worth, FL 33460-6250
Phone
(561) 582-0330
Fax
(561) 582-0339
NPI assigned
Dec 1, 2006
Last updated
Nov 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X ME99529 FL
Internal Medicine Physician 207R00000X ME99529 FL Primary

Addresses

Primary practice location

2531 N Dixie Hwy
Lake Worth, FL 33460-6250

Mailing address

2531 N Dixie Hwy
Lake Worth, FL 33460-6250
Phone (561) 582-0330

Other identifiers 1

IdentifierTypeStateIssuer
2803080100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080508000296 FL Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - DermatologyPractitioner - Geriatric MedicinePractitioner - EndocrinologyPractitioner - Pain ManagementPractitioner - Critical Care (Intensivists)Practitioner - Emergency Medicine 5496735342 Reassigns benefits to 1 organization
Practice locations: North Miami Beach, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Heisu Research Group LLC CurrentSince Nov 5, 2023 Accepting new patients
Hyperbaric Therapy of Florida, Inc PastSince Feb 28, 2018 Accepting new patients
RJBV Internal Medicine, PSC Past Accepting new patients
Leonardo Rodriguez M.D. P.a. Past Accepting new patients
Evidence Base Medical Internal Medicine PastSince Aug 1, 2015 Accepting new patients
Bergen Orthopedics, Inc. Past Accepting new patients

Locations

100 NW 170th St
Ste 105
North Miami Beach, FL 33169
Phone (305) 654-5069

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1477621373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2531 N DIXIE HWY",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334606250",
            "telephone_number": "561-582-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2531 N DIXIE HWY",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334606250",
            "telephone_number": "561-582-0330",
            "fax_number": "561-582-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "GONZALO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME99529",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME99529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2803080100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.