Individual provider Active NPI

Luis Enrique Gonzalez, MD

  • Diagnostic Radiology Physician
  • Palm Coast, FL
National Provider Identifier
1740712272
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME147779 Issued in FL
Practice address
60 Memorial Medical Pkwy
Palm Coast, FL 32164-5980
Phone
(386) 586-2000
Fax
(317) 705-5047
NPI assigned
Apr 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X ME147779 FL Primary

Addresses

Primary practice location

60 Memorial Medical Pkwy
Palm Coast, FL 32164-5980

Mailing address

401 Palmetto St
New Smyrna Beach, FL 32168-7322
Phone (386) 424-5140

Other practice location 1

401 Palmetto St
New Smyrna Beach, FL 32168-7322
Phone (386) 424-5140

Other practice location 2

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lgonzalez1748935@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220613002008 FL Practitioner - Diagnostic Radiology 0345599874 Reassigns benefits to 3 organizations
I20241107003361 KY Practitioner - Diagnostic Radiology 0345599874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of South Florida College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0042383200, 329 clinicians
Florida Radiology Imaging at Lake Mary LLCGroup PAC ID 1254311137, 273 clinicians
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

1055 Saxon Blvd
Orange City, FL 32763-8468
Phone (386) 917-5000

1480 W Orange Blossom TRL
Adventhealth Imaging Apopka
Apopka, FL 32712-2637
Phone (407) 200-5440

1551 Future Way
Adventhealth Imaging
Celebration, FL 34747-4489
Phone (407) 303-4041

1919 E Hwy 50 101
Adventhealth Imaging Center Clermon
Clermont, FL 34711-1975
Phone (352) 717-3738

200 N Lakemont Ave
Winter Park, FL 32792-3273
Phone (407) 646-7000

2000 Fowler Grove Blvd
Winter Garden, FL 34787-5050
Phone (407) 200-2355

210 Marie Langdon Dr
Manchester, KY 40962-6388
Phone (606) 598-5104

2200 Fowler Grove Blvd
Suite 60
Winter Garden, FL 34787-5597
Phone (407) 200-0538

235 E Princeton St
Suite 100
Orlando, FL 32804-5554
Phone (407) 303-1414

2450 N Orange Blossom TRL
Kissimmee, FL 34744-2316
Phone (407) 846-4343

2488 E Irlo Bronson Memorial Hwy
Ahi Partin Settlement
Kissimmee, FL 34744-4948
Phone (407) 200-5440

25 S Terry Ave
Suite 220
Orlando, FL 32805-1843
Phone (407) 641-2446

2501 N Orange Ave
Orlando, FL 32804-4641

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone (386) 231-6000

400 Celebration PL
Celebration, FL 34747-4970
Phone (407) 764-4000

60 Memorial Medical Pkwy
Palm Coast, FL 32164-5980
Phone (386) 586-2000

601 E Altamonte Dr
Altamonte SPG, FL 32701-4802
Phone (407) 830-4321

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-5600

661 E Altamonte Dr
Suite 130
Altamonte Springs, FL 32701-5102
Phone (407) 303-2155

701 W Plymouth Ave
Deland, FL 32720-3236
Phone (386) 943-4522

7727 Lake Underhill Rd
Orlando, FL 32822-8224
Phone (407) 303-8110

900 Winderley PL
Suite 1100
Maitland, FL 32751-7229
Phone (407) 200-2355

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Adventhealth Waterman Hospital, Tavares, FL, CCN 100057
  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
  • Adventhealth Deland Hospital, Deland, FL, CCN 100045
  • Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME147779FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Jul 17, 2023 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jul 17, 2023 Accepting new patients
Florida Radiology Imaging at Lake Mary LLC Diagnostic Radiology CurrentSince Oct 24, 2022 Accepting new patients
Florida Radiology Imaging at Lake Mary, LLC Diagnostic Radiology CurrentSince Oct 24, 2022 Accepting new patients
Florida Hospital Medical Group Inc Diagnostic Radiology CurrentSince Oct 24, 2022 Accepting new patients

Locations

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

900 Winderley Pl
Ste 1100
Maitland, FL 32751
Phone (407) 200-1606

401 Palmetto St
New Smyrna Beach, FL 32168
Phone (386) 424-5000

235 E Princeton St
Ste 100
Orlando, FL 32804
Phone (407) 303-1414

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

210 Marie Langdon Dr
Manchester, KY 40962
Phone (865) 985-7047

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: lgonzalez1823386@adventhealth.direct-ci.com
  • Direct secure messaging: lgonzalez1748935@ehrdirect.mayoclinicmsg.org

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1740712272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 PALMETTO ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687322",
            "telephone_number": "386-424-5140",
            "fax_number": "317-705-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MEMORIAL MEDICAL PKWY",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645980",
            "telephone_number": "386-586-2000",
            "fax_number": "317-705-5047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Palmetto St",
            "address_purpose": "LOCATION",
            "city": "New Smyrna Beach",
            "state": "FL",
            "postal_code": "321687322",
            "country_code": "US",
            "telephone_number": "386-424-5140",
            "fax_number": "317-705-5047",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4500 San Pablo Rd S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322241865",
            "country_code": "US",
            "telephone_number": "904-953-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "LUIS",
        "middle_name": "ENRIQUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME147779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgonzalez1748935@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.