Active NPI
Ernesto Matos-Gonzalez, MD
- Child & Adolescent Psychiatry Physician
- Hialeah, FL
National Provider Identifier
1578514865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- ME 91140
- Practice address
- 4385 W 16TH Ave
Hialeah, FL 33012-7628 - Phone
- (305) 824-0637
- NPI assigned
- May 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | ME 91140 | FL | Primary |
Addresses
Primary practice location
4385 W 16TH Ave
Hialeah, FL 33012-7628
Mailing address
11031 NE 6TH Ave
Miami, FL 33161-7182
Phone (305) 398-6102
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 270568100 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 91140 | FL | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546992000000",
"number": "1578514865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11031 NE 6TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331617182",
"telephone_number": "305-398-6102",
"fax_number": "305-757-4465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4385 W 16TH AVE",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330127628",
"telephone_number": "305-824-0637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATOS-GONZALEZ",
"first_name": "ERNESTO",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-12",
"last_updated": "2019-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "FL",
"license": "ME 91140",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "270568100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.