Basic Information
| Provider Information | |||||||||
| NPI: | 1164542940 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOZO | ||||||||
| FirstName: | FELIX | ||||||||
| MiddleName: | ROSEL | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1320 INVERNESS LANE | ||||||||
| Address2: | |||||||||
| City: | SCHERERVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 46375 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2193229437 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1354 S LAKE PARK AVENUE | ||||||||
| Address2: | ST MARYS SPECTRUM REHAB CENTER CARDIAC | ||||||||
| City: | HOBART | ||||||||
| State: | IN | ||||||||
| PostalCode: | 46342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2199476089 | ||||||||
| FaxNumber: | 2199476356 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208G00000X | 01033486A | IN | Y | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
No ID Information.