Provider Demographics
NPI:1114449022
Name:GONZALEZ COSME, JAVIER ALEJANDRO (MD)
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:ALEJANDRO
Last Name:GONZALEZ COSME
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3170 CORAL WAY #1803
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3363
Mailing Address - Country:US
Mailing Address - Phone:787-454-4408
Mailing Address - Fax:
Practice Address - Street 1:5040 NW 7TH ST STE 635
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3796
Practice Address - Country:US
Practice Address - Phone:305-644-2212
Practice Address - Fax:786-475-7787
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22156208D00000X
FLME156003207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice