HORACIO GONZALEZ MD PA
Ambulatory Health at State Road 436, Casselberry, FL

License number
Florida ME41239
Category
Ambulatory Health
Type
Primary Care
Owner
Name: DR. HORACIO GONZALEZ M.D
Title: OWNER
Phone: (407) 834-3730
Address
Address
515 State Road 436 SUITE 1006, Casselberry, FL 32707
National Provider ID: 1083872725
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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HORACIO GONZALEZ, M.D., PA

Casselberry, FL  -  Altamonte Springs, FL

Status:
Inactive
Doing business as:
Horacio Gonzalez MD
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Mar 6, 2003
Inactive since:
Sep 24, 2010
Phone:
(407) 834-3730 (Phone)
Addresses:
515 State Rd 436 STE 1006, Casselberry, FL 32707 (Physical)
1007 E Altamonte Dr, Altamonte Springs, FL 32701
State ID:
P03000027524
Business type:
Florida Profit Corporation
President, Secretary, Director:
Horacio M.d. Gonzalez President, Secretary, Director, inactive, 856 Sun Ct SUITE 1006, Altamonte Springs, FL 32701 (Physical)
Agent:
Horacio Gonzalez,856 Sun Ct, Altamonte Springs, FL 32701 (Physical)
EIN:
364525332

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