Provider Demographics
NPI:1447285606
Name:GONZALEZ & CASTELLANOS, M.D., P.A.
Entity type:Organization
Organization Name:GONZALEZ & CASTELLANOS, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERARDO
Authorized Official - Middle Name:ARMANDO
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-824-3604
Mailing Address - Street 1:2387 W 68TH ST
Mailing Address - Street 2:SUITE #304
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6816
Mailing Address - Country:US
Mailing Address - Phone:305-824-3604
Mailing Address - Fax:305-826-1300
Practice Address - Street 1:2387 W 68TH ST
Practice Address - Street 2:SUITE #304
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-6816
Practice Address - Country:US
Practice Address - Phone:305-824-3604
Practice Address - Fax:305-826-1300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
24379Medicare ID - Type Unspecified