Organization Active NPI

Miguel a Gonzalez M.D. P.a

  • Health Service Clinic/Center
  • Fort Lauderdale, FL
National Provider Identifier
1902163801
Registry record updated Apr 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
24288 Issued in FL
Legal business name
MIGUEL A GONZALEZ M.D. P.A
Practice address
401 SE 16TH St
Fort Lauderdale, FL 33316-2529
Phone
(954) 523-8108
Fax
(954) 525-9828
NPI assigned
Apr 16, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2012

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

Authorized official

Name
Dr. Miguel Angel Gonzalez, M.D.
Title
President
Phone
(954) 523-8108

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 24288 FL Primary

Addresses

Primary practice location

401 SE 16TH St
Fort Lauderdale, FL 33316-2529

Mailing address

401 SE 16TH St
Fort Lauderdale, FL 33316-2529
Phone (954) 523-8108

Other identifiers 1

IdentifierTypeStateIssuer
035917300MedicaidFL

National Provider Directory

National Provider Directory

Locations

1600 S Andrews Ave
Ste 321
Ft Lauderdale, FL 33316
Phone (954) 355-5110

401 SE 16th St
Ft Lauderdale, FL 33316
Phone (954) 523-8108

Practitioners & affiliated clinicians

Practitioners 1

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": "1334534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334534400000",
    "number": "1902163801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 SE 16TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162529",
            "telephone_number": "954-523-8108",
            "fax_number": "954-525-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SE 16TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162529",
            "telephone_number": "954-523-8108",
            "fax_number": "954-525-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIGUEL A GONZALEZ M.D. P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-16",
        "last_updated": "2012-04-16",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "ANGEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-523-8108",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "24288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035917300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2012; 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.