E. Gonzalez MD PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

E. GONZALEZ MD PA

Practice address

4755 Summerlin Rd Ste 8
Fort Myers, FL 33919-1073

Phone

(239) 275-5339

Fax

(239) 275-5592

NPI assigned

Jan 7, 2011

Organization subpart

No

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

Authorized official

Name

Dr. E Gonzalez, MD PA

Title

Owner/Doctor

Phone

(239) 275-5339

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1294358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294358400000",
    "number": "1982908760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4755 SUMMERLIN RD STE 8",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339191073",
            "telephone_number": "239-275-5339",
            "fax_number": "239-275-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 SUMMERLIN RD STE 8",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339191073",
            "telephone_number": "239-275-5339",
            "fax_number": "239-275-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E. GONZALEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-07",
        "last_updated": "2011-01-07",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "E",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "239-275-5339",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD PA"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036797400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; 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.