Active NPI
Sandra Gonzalez, MD
- Psychiatry Physician
- Melbourne, FL
National Provider Identifier
1992747919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME0079036
- Practice address
- 400 E Sheridan Rd
Melbourne, FL 32901-3122 - Phone
- (321) 634-6264
- NPI assigned
- Jun 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ME0079036 | FL | Primary |
Addresses
Primary practice location
400 E Sheridan Rd
Melbourne, FL 32901-3122
Mailing address
400 E Sheridan Rd
Melbourne, FL 32901-3122
Phone (321) 634-6264
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3159 | Other | FL | BCBSFL |
| 261476600 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0079036 | FL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320278400000",
"number": "1992747919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 E SHERIDAN RD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329013122",
"telephone_number": "321-634-6264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 E SHERIDAN RD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329013122",
"telephone_number": "321-634-6264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "SANDRA",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-12",
"last_updated": "2011-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME0079036",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSFL",
"identifier": "3159",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "261476600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.