Active NPI
Miguel a Gonzalez M.D. P.a
- Health Service Clinic/Center
- Fort Lauderdale, FL
National Provider Identifier
1902163801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Clinic/Center
- License
- 24288
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 035917300 | Medicaid | FL |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Advanced Practice Midwife
- Fort Lauderdale, FL
- NPI 1134121767
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.