| Doctor Name: | DR. EDWIN GONZALEZ |
| NPI Number: | 1043286784 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 6606 |
| Business Practice Address: | Spring Rd Bldg 1806 Branch Health Clinic, Naval Weapons Station Yorktown, VA - 23691 |
| Business Phone Number: | 7573146129 |
| Business Fax Number: | |
| Mailing Address: | 452 Thalia Rd, VIRGINIA BEACH |
| State: | VA |
| Postal Code: | 234521853 |
| Phone Number: | 7574312333 |
| Fax Number: | 7573147355 |
| NPI Enumeration Date: | 02/23/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 6606 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |