Active NPI
Jose R. Gonzalez, MSW, LCSW
- Clinical Social Worker
- Ft Lauderdale, FL
National Provider Identifier
1619252087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW6641
- Practice address
- 501 SE 18TH CT
Ft Lauderdale, FL 33316-2833 - Phone
- (954) 522-4749
- Fax
- (954) 522-9357
- NPI assigned
- Oct 18, 2011
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ISW6641 | FL | Primary |
Addresses
Primary practice location
501 SE 18TH CT
Ft Lauderdale, FL 33316-2833
Mailing address
1726 SE 3Rd Ave
Ft Lauderdale, FL 33316-2514
Phone (954) 522-4749
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW6641 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Broward House, Inc. | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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": "1318896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318896000000",
"number": "1619252087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1726 SE 3RD AVE",
"city": "FT LAUDERDALE",
"state": "FL",
"postal_code": "333162514",
"telephone_number": "954-522-4749",
"fax_number": "954-522-9357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 SE 18TH CT",
"city": "FT LAUDERDALE",
"state": "FL",
"postal_code": "333162833",
"telephone_number": "954-522-4749",
"fax_number": "954-522-9357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "JOSE",
"middle_name": "R.",
"credential": "MSW, LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-18",
"last_updated": "2011-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "ISW6641",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.