Individual ProviderEduardo GonzalezFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address13330 Usf Laurel Dr, Tampa, FL 33612-6601(813) 974-2201PECOS EnrollmentBased on the most recent information from CMS, provider Eduardo Gonzalez is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 10:41 AM.Profile DetailsProvider ID1235167214Provider TypeIndividualFull NameGonzalez, EduardoCredentialMDGenderMaleSole ProprietorNoEnumeration Date6/29/2006Last Updated4/5/2021Contact InformationPractice LocationPractice Address13330 Usf Laurel Dr, Tampa, FL 33612-6601Phone(813) 974-2201FaxUnlisted FaxMailing LocationMailing AddressPO Box 917770, Orlando, FL 32891-0001PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseME0062920FloridaProvider IdentifiersIDDescriptionIssuerID25781DescriptionOtherIssuerBLUE CROSS BLUE SHIELDFloridaID375956300DescriptionMedicaidIssuerUnlistedFlorida