Individual provider Active NPI

Sandino A Gonzalez, M.D.

  • Internal Medicine Physician
  • South Miami, FL
National Provider Identifier
1720010317
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME75564 Issued in FL
Practice address
6150 Sunset Dr
Suite 200
South Miami, FL 33143-5040
Phone
(305) 274-9890
Fax
(305) 661-2794
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME75564 FL Primary

Addresses

Primary practice location

6150 Sunset Dr
Suite 200
South Miami, FL 33143-5040

Mailing address

6150 Sunset Dr
Suite 200
South Miami, FL 33143-5040
Phone (305) 274-9890

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
I20110427000115 FL Practitioner - Internal Medicine 8123202090

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME75564FLMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1720010317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 SUNSET DR",
            "address_2": "SUITE 200",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435040",
            "telephone_number": "305-274-9890",
            "fax_number": "305-661-2794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 SUNSET DR",
            "address_2": "SUITE 200",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435040",
            "telephone_number": "305-274-9890",
            "fax_number": "305-661-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "SANDINO",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME75564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.