Gonzalez, Jorge Antonio

Gonzalez, Jorge Antonio is an individual health care provider with primary practice located at 3333 W Commercial Blvd Ste 101 , Fort Lauderdale FL 33309-3424. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Gonzalez, Jorge Antonio can be contacted via phone (954) 751-6990.

Contact Information

Primary practice address
3333 W Commercial Blvd Ste 101 Fort Lauderdale FL 33309-3424
Phone: (954) 751-6990
Fax: (954) 751-6991
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207RS0010X ME128315 Florida
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME128315 Florida

Profile Details

NPI number 1427390137
LBN Legal business name Gonzalez, Jorge Antonio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2013
Last updated Mar 17th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427390137 NPPES
Florida MEDICAID 017619600

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