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JUSTO GONZALEZ, M.D.
NPI 1336337690
Specialist in Titusville, FL

Active since October 11, 2007CLIA 10D1035171 · Waiver
2203 GARDEN ST, TITUSVILLE, FL 32796(321) 268-4693(321) 268-4696 Get Directions Write a Review

NPPES record last updated: March 13, 2009. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Justo Gonzalez, M.d. NPPES

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

JUSTO GONZALEZ, M.D. (NPI 1336337690) is a healthcare organization registered as a specialist in Titusville, Florida and active in the NPI registry since October 2007. The organization holds a CLIA Waiver certificate valid through December 21, 2026 and lists Justo Gonzalez, Urologist, as its authorized official.

NPPES Registry Identity

NPI1336337690
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSPACE COAST UROLOGY, LLC
Location Address2203 GARDEN STTitusville, FL 32796-2577
Mailing Address2203 Garden StTitusville, FL 32796-2577 · (321) 268-4693 · Fax (321) 268-4696
Phone(321) 268-4693
Fax(321) 268-4696
Organization SubpartNo
Authorized OfficialJusto GonzalezUrologist · (321) 268-4693
Enumeration DateOctober 11, 2007
Last NPPES UpdateMarch 13, 2009
✔ NPI 1336337690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in FL · ME67177
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
2203 GARDEN ST, Titusville, FL 32796
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Other Names 1

Doing Business AsJusto Gonzalez, M.d.

Other Identifiers 3

Medicare UPINC61963FL
Medicaid271696800FL
Medicare PINK7029FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justo Gonzalez, M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Justo Gonzalez, M.D., which bills Medicare for the services this clinician delivers.

Clinician (1)

Justo Gonzalez, M.D.
Urology
NPI 1639204019
4420 S HOPKINS AVE
Titusville, FL 32780
(321) 268-4693
✔ PECOS✔ Accepts Medicare4.2 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1035171

Space Coast Urology LLC · Titusville, FL
Active · expires Dec 21, 2026
CLIA Number10D1035171
Laboratory TypePhysician Office
Certificate Effective DateDecember 22, 2024
Certificate Expiration DateDecember 21, 2026
Laboratory DirectorJusto Gonzalez
Laboratory Phone(321) 268-4693
Laboratory LocationSpace Coast Urology LLC4420 S Hopkins Ave, Titusville, FL 32780
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Space Coast Urology, LLC's NPI number?

The NPI number for Space Coast Urology, LLC is 1336337690. It was assigned to this organization in the NPPES registry on October 11, 2007. The provider is doing business as Justo Gonzalez, M.D..

Where is Space Coast Urology, LLC located?

Space Coast Urology, LLC is located at 2203 Garden St, Titusville, FL 32796. The listed phone number is (321) 268-4693.

What is Space Coast Urology, LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Space Coast Urology, LLC enrolled in Medicare?

Yes. Space Coast Urology, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Space Coast Urology, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Urology) reassigns their Medicare billing to Space Coast Urology, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Space Coast Urology, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1035171) is associated with this NPI, valid through December 21, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Space Coast Urology, LLC was last updated on March 13, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.