Gonzalez, Justo

Gonzalez, Justo is an sole proprietor health care provider with primary practice located at 4420 S Hopkins Ave , Titusville FL 32780-6690. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Gonzalez, Justo can be contacted via phone (321) 268-4693.

Contact Information

Primary practice address
4420 S Hopkins Ave Titusville FL 32780-6690
Fax: (321) 268-4696
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME67177 Florida

Profile Details

NPI number 1639204019
LBN Legal business name Gonzalez, Justo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 23rd, 2007
Last updated Feb 1st, 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 1639204019 NPPES
Florida MEDICAID 2716968-00

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