Individual provider · Type 1 NPI

Bryan Gonzalez, PA-C

Physician Assistant · Davie, FL

NPI number 1104688563 Active

Practice location

4765 SW 148th Ave Ste 404
Davie, FL 33330-2128

Fax (954) 374-7543

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XPA9118524 (FL)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1104688563

Bryan Gonzalez, PA-C's National Provider Identifier is 1104688563, issued on Jan 30, 2024. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Davie, FL. The record was last updated on Aug 11, 2025.