| Organization Name: | LUIS F GONZALEZ, III, MD, PC |
| NPI Number: | 1073516126 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHELLE DOUGLAS (CREDENTIALING MANAGER) |
| Mailing Address: | 118 Consumer Sq Plattsburgh |
| State: | NY US |
| Postal Code: | 129016507 |
| Phone Number: | 5185623650 |
| Fax Number: | 5185623801 |
| NPI Enumeration Date: | 05/23/2005 |
| NPI Last Update Date: | 06/12/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Magnetic Resonance Imaging (MRI) |
| Taxonomy Definition: | |