1. Home
  2. Directory
  3. Florida
  4. Davie
  5. Physician Assistant
  6. NPI Profile

BRYAN GONZALEZ PA-C
NPI 1104688563
Physician Assistant in Davie, FL

Active since January 30, 2024PECOS EnrolledAccepts Medicare Assignment
4765 SW 148TH AVE STE 404, DAVIE, FL 33330(954) 374-7545(954) 374-7543 Get Directions Write a Review

NPPES record last updated: August 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 11, 2025, Jun 3, 2024 (2 updates tracked since 2024).

About Bryan Gonzalez Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRYAN GONZALEZ PA-C (NPI 1104688563) is an individual physician assistant in Davie, Florida, licensed in Florida (PA9118524) and active in the NPI registry since January 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1104688563
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameBRYAN GONZALEZCredential: PA-C
Location Address4765 SW 148TH AVE STE 404Davie, FL 33330-2128
Mailing Address4765 Sw 148th Ave Ste 404Davie, FL 33330-2128 · (954) 374-7545 · Fax (954) 374-7543
Phone(954) 374-7545
Fax(954) 374-7543
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateJanuary 30, 2024
Last NPPES UpdateAugust 11, 20252 updates tracked since enumeration
NPPES CertifiedAugust 11, 2025
✔ NPI 1104688563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in FL · PA9118524
Definition
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, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
4765 SW 148TH AVE STE 404, Davie, FL 33330
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Bryan Gonzalez Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537661871
PECOS Enrollment IDI20250905004047
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33330 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$91.69 typical visit price
range $58.56 – $179.05
Typical copayment $22.92 (range $14.64 – $44.76)
Most-billed visit code 99203
Established Patient
$73.00 typical visit price
range $18.44 – $144.68
Typical copayment $18.25 (range $4.61 – $36.17)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PERSONALIZED MEDICINE INSTITUTE, LLC.
Internal Medicine (Cardiovascular Disease)
4765 SW 148TH AVE STE 404
DAVIE, FL 33330
Broward County (203) 300-0147
DR. IVEL CRISTINA DE FREITAS M.D.
Internal Medicine
4765 SW 148TH AVE STE 404
DAVIE, FL 33330
Broward County (203) 300-0147

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bryan Gonzalez's NPI number?

The NPI number for Bryan Gonzalez is 1104688563. It was assigned to this individual provider in the NPPES registry on January 30, 2024.

Where is Bryan Gonzalez located?

Bryan Gonzalez practices at 4765 SW 148th Ave Ste 404, Davie, FL 33330. The listed phone number is (954) 374-7545.

What is Bryan Gonzalez's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Bryan Gonzalez enrolled in Medicare?

Yes. Bryan Gonzalez is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Bryan Gonzalez was last updated on August 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.