Provider Demographics
NPI:1427120500
Name:GONZALEZ, HECTOR (MPAS)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 E AMANDA CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32259-4548
Mailing Address - Country:US
Mailing Address - Phone:904-230-6859
Mailing Address - Fax:
Practice Address - Street 1:2804 SAINT JOHNS BLUFF RD S STE 109
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-3777
Practice Address - Country:US
Practice Address - Phone:904-727-9123
Practice Address - Fax:904-855-4255
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical