Gonzalez, Leopoldo B

Gonzalez, Leopoldo B is an sole proprietor health care provider with primary practice located at 301 Health Park Blvd Anderson Gibbs Bldg., Suite 221, St Augustine FL 32086-5793. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Gonzalez, Leopoldo B can be contacted via phone (904) 824-4277.

Contact Information

Primary practice address
301 Health Park Blvd Anderson Gibbs Bldg., Suite 221 St Augustine FL 32086-5793
Phone: (904) 824-4277
Fax: (904) 824-4490
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME0022097 Florida

Profile Details

NPI number 1154346153
LBN Legal business name Gonzalez, Leopoldo B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 12th, 2006
Last updated Jan 8th, 2009 - about 17 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 1154346153 NPPES
Florida MEDICAID 054187700

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