Organization Active NPI

Evidence Base Medical

  • Internal Medicine Physician
  • Hollywood, FL
National Provider Identifier
1700252624
Registry record updated Aug 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EVIDENCE BASE MEDICAL
Practice address
5920 Johnson St
Suite 108
Hollywood, FL 33021-5652
Phone
(954) 967-4795
NPI assigned
Aug 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2015

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

Authorized official

Name
Gonzalo Gonzalez, MDNPI 1477621373
Title
Director
Phone
(954) 967-4795

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

5920 Johnson St
Suite 108
Hollywood, FL 33021-5652

Mailing address

5920 Johnson St
Suite 108
Hollywood, FL 33021-5652
Phone (954) 967-4795

National Provider Directory

National Provider Directory

Locations

5920 Johnson St
Ste 108
Hollywood, FL 33021
Phone (954) 967-4795

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439510400000",
    "number": "1700252624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 JOHNSON ST",
            "address_2": "SUITE 108",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215652",
            "telephone_number": "954-967-4795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 JOHNSON ST",
            "address_2": "SUITE 108",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215652",
            "telephone_number": "954-967-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVIDENCE BASE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-14",
        "last_updated": "2015-08-14",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "GONZALO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "954-967-4795",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.