Individual provider Active NPI

Richard Gonzalez, D.O.

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1588756100
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS4666 Issued in FL
Practice address
232 N Orange Blossom TRL
Orlando, FL 32805-1612
Phone
(407) 428-5751
Fax
(407) 428-6204
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X OS4666 FL
Pediatrics Physician 208000000X OS4666 FL Primary

Addresses

Primary practice location

232 N Orange Blossom TRL
Orlando, FL 32805-1612

Mailing address

232 N Orange Blossom TRL
Orlando, FL 32805-1612
Phone (407) 428-5751

Other identifiers 1

IdentifierTypeStateIssuer
254597700MedicaidFL

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
I20070806000408 FL Practitioner - Pediatric MedicinePractitioner - Family Practice 3274624275 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers, Inc Current Accepting new patients
Community Health Centers, Inc. CurrentSince Aug 22, 2016 Accepting new patients
Community Health Centers, Inc Current Accepting new patients
Community Health Centers, Inc CurrentSince Aug 22, 2016 Accepting new patients

Locations

225 E 7th St
Apopka, FL 32703
Phone (407) 886-6201

7900 Forest City Rd
Orlando, FL 32810
Phone (407) 614-5337

840 Mercy Dr
Pine Hills, FL 32808

110 S Woodland St
Winter Garden, FL 34787

13275 W Colonial Dr
Winter Garden, FL 34787

Organizations & group practices 4

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1588756100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 N ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328051612",
            "telephone_number": "407-428-5751",
            "fax_number": "407-428-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 N ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328051612",
            "telephone_number": "407-428-5751",
            "fax_number": "407-428-6204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "OS4666",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS4666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254597700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.