Provider Demographics
NPI:1194732263
Name:GONZALEZ, RAMON ANTONIO (DC)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:ANTONIO
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5617 NAPLES BLVD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109
Mailing Address - Country:US
Mailing Address - Phone:239-591-2220
Mailing Address - Fax:239-591-3873
Practice Address - Street 1:5617 NAPLES BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109
Practice Address - Country:US
Practice Address - Phone:239-591-2220
Practice Address - Fax:239-591-3873
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5955111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL53898OtherBCBS FL PROVIDER
22390OtherBCBS OF FL
FL53898ZOtherMEDICARE PROVIDER #
FL5277357OtherAETNA PROVIDER
FLK3777OtherMEDICARE GROUP #
FL380167500Medicaid
U12690Medicare UPIN
FL5277357OtherAETNA PROVIDER