Individual provider Active NPI

Pedro Gonzalez, PA

  • Gastroenterology Physician
  • Miami Springs, FL
National Provider Identifier
1801039938
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
PA9100617 Issued in FL
Practice address
1259 Bluebird Ave
Miami Springs, FL 33166-3117
Phone
(305) 275-7029
Fax
(305) 275-7066
NPI assigned
Apr 20, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X PA9100617 FL Primary

Addresses

Primary practice location

1259 Bluebird Ave
Miami Springs, FL 33166-3117

Mailing address

1259 Bluebird Ave
Miami Springs, FL 33166-3117
Phone (305) 275-7029

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9100617FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando F. Torres PA CurrentSince Feb 2, 2002 Accepting new patients
Pedro Gonzalez PA Past Accepting new patients
Alberto Alea M D P a Past Accepting new patients

Locations

4791 W 4th Ave
Hialeah, FL 33012
Phone (305) 825-0500

Organizations & group practices 3

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": "1240185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240185600000",
    "number": "1801039938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 BLUEBIRD AVE",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331663117",
            "telephone_number": "305-275-7029",
            "fax_number": "305-275-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 BLUEBIRD AVE",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331663117",
            "telephone_number": "305-275-7029",
            "fax_number": "305-275-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "PEDRO",
        "name_prefix": "Dr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-20",
        "last_updated": "2009-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "PA9100617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; 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.