Michelle Gonzalez OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3797 Issued in FL

Legal business name

MICHELLE GONZALEZ OD PA

Practice address

4300 W Oakland Park Blvd
Lauderdale Lakes, FL 33313-1918

Phone

(954) 484-0700

Fax

(954) 484-0705

NPI assigned

Sep 19, 2007

Organization subpart

No

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

Authorized official

Name

Michelle Gonzalez, O.D.

Title

President

Phone

(954) 484-0700

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1962698431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 W OAKLAND PARK BLVD",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333131918",
            "telephone_number": "954-484-0700",
            "fax_number": "954-484-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W OAKLAND PARK BLVD",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333131918",
            "telephone_number": "954-484-0700",
            "fax_number": "954-484-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE GONZALEZ OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-484-0700",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.