Female

Tara Gonzalez M.D.

Family Medicine Physician in Port Orange, FL(View on Map)

Full Name

Tara Gonzalez M.D.

NPI Number

1831503010

NPI Type

Individual Provider

Gender

Female

Enumeration Date

06/16/2014

Specialties

(Taxonomies)

Code

207Q00000X
208M00000X

Primary Taxonomy

Yes
No

Licenses

State

Florida

License Number

ME125379

Contact
Information

Purpose

Mailing
Location

Address

790 DUNLAWTON AVE STE E
790 DUNLAWTON AVE STE E

City

Port Orange
Port Orange

State

FL
FL

Postal Code

32127-4222
32127-4222

Country

US
US

Telephone Number

(386) 760-1877
(386) 760-1877

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/18/2024

Provider Address

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