Individual provider Active NPI

Manuel D Gonzalez, M.D.

  • Internal Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1497740112
Registry record updated Apr 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME65082 Issued in FL
Practice address
2295 N University Dr
Pembroke Pines, FL 33024-3611
Phone
(954) 983-1969
Fax
(954) 983-1980
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5201 Hollywood Blvd
Suite 2
Hollywood, FL 33021-6422
Phone (954) 228-6619

Hospital & facility affiliations

  • Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281

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
I20101112001205 FL Practitioner - Internal Medicine 0749256428 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of Hollywood LLC CurrentSince Feb 1, 2022 Accepting new patients
Health Associates, LLC Internal Medicine CurrentSince Jan 18, 2023 Accepting new patients
Physicians Care Plus Internal Medicine PastSince Sep 1, 2004 Accepting new patients
Dr Kenneth Blaze PA and Associates Internal Medicine PastSince Jul 1, 2010 Accepting new patients
Rma of Sunrise LLC Internal Medicine PastSince Dec 14, 2013 Accepting new patients
Rma of Hallandale LLC Internal Medicine PastSince Dec 14, 2013 Accepting new patients

Locations

5201 Hollywood Blvd
#2
Hollywood, FL 33021
Phone (954) 228-6619

2295 N University Dr
Pembroke Pines, FL 33024
Phone (954) 932-0132

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME65082 FL Primary

Addresses

NPPES NPI Registry

Primary practice location

2295 N University Dr
Pembroke Pines, FL 33024-3611

Mailing address

7800 W Oakland Park Blvd
Suite E-214
Sunrise, FL 33351-6741
Phone (954) 318-6590

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
375385900MedicaidFL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 25, 2014.

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398384000000",
    "number": "1497740112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 W OAKLAND PARK BLVD",
            "address_2": "SUITE E-214",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516741",
            "telephone_number": "954-318-6590",
            "fax_number": "954-318-6604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 N UNIVERSITY DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243611",
            "telephone_number": "954-983-1969",
            "fax_number": "954-983-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MANUEL",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2014-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME65082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375385900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.