Patrick M. Gonzalez, M.D., P.a.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

ME 67553 Issued in FL

Legal business name

PATRICK M. GONZALEZ, M.D., P.A.

Practice address

1420 SW Saint Lucie West Blvd
Suite 102
Port Saint Lucie, FL 34986-1709

Phone

(772) 873-1005

Fax

(772) 873-9106

NPI assigned

Aug 10, 2010

Organization subpart

No

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

Authorized official

Name

Patrick M Gonzalez, M.D.NPI 1447364534

Title

Ownerr

Phone

(772) 873-1005

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

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

• Patrick M. Gonzalez, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Port St Lucie, FL
  • NPI 1447364534
  Medicare reassignment NPD Authorized official
• Miguel Antonio Tabaro, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Cutler Bay, FL
  • NPI 1073538138
  NPD (past)

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281398400000",
    "number": "1851606263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 SW SAINT LUCIE WEST BLVD",
            "address_2": "SUITE 102",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861709",
            "telephone_number": "772-873-1005",
            "fax_number": "772-873-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 SW SAINT LUCIE WEST BLVD",
            "address_2": "SUITE 102",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861709",
            "telephone_number": "772-873-1005",
            "fax_number": "772-873-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK M. GONZALEZ, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-10",
        "last_updated": "2010-08-10",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNERR",
        "authorized_official_telephone_number": "772-873-1005",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME 67553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377982300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roshni Patel, DMD
• Tulsi Patel, OD
• Parthiv Mouleshkumar Pathak, PT
• Huzayfah Iqbal Pathan
• Muhammad Iqbal Pathan, MD
• Treasure Serenity Patrick
• Abby Lynn Pattengale
• Russell Anthony Patti Jr., RPH. NP
• Mike Paul
• Barbara Ann Paulger, C.O.T,A.

• Physical Medicine & Rehabilitation Physician in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.