Provider Demographics
NPI:1942029533
Name:RAFAEL ANGEL GONZALEZ MD PA
Entity type:Organization
Organization Name:RAFAEL ANGEL GONZALEZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:305-702-9441
Mailing Address - Street 1:7150 W 20TH AVE STE 412E
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5533
Mailing Address - Country:US
Mailing Address - Phone:305-702-9441
Mailing Address - Fax:305-702-9442
Practice Address - Street 1:7150 W 20TH AVE STE 615
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5511
Practice Address - Country:US
Practice Address - Phone:305-702-9441
Practice Address - Fax:305-702-9442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-09
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty