Provider Demographics
NPI:1235346115
Name:GONZALEZ, DARSHAM YUSSEF (MD)
Entity type:Individual
Prefix:
First Name:DARSHAM
Middle Name:YUSSEF
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4851 ANCIENT MARBLE DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-4701
Mailing Address - Country:US
Mailing Address - Phone:941-586-8995
Mailing Address - Fax:
Practice Address - Street 1:2001 W 86TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1902
Practice Address - Country:US
Practice Address - Phone:317-338-2345
Practice Address - Fax:317-583-3099
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01096080A207R00000X
TXT5741208M00000X
FLME102159207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL61545OtherBLUE CROSS & BLUE SHIELD OF FLORIDA
I14405Medicare UPIN
FLBA010XMedicare PIN