Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bryan Gonzalez, PA-C

Individual provider Physician Assistant · NPI 1104688563

Bryan Gonzalez, PA-C is a Physician Assistant in Davie, Florida. Qualified in 2023, 3 years ago. Practices with Personalized Medicine Institute LLC, a 3-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
3
Licensed in
FL
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4765 SW 148th Ave Ste 404
Davie, FL 33330-2128
Phone: (954) 374-7545
Fax: (954) 374-7543
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9118524 (FL)

Record details

NPI number1104688563
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJanuary 30, 2024
Last updated in NPPESAugust 11, 2025
Certification dateAugust 11, 2025
Mailing address4765 Sw 148th Ave Ste 404, Davie, FL 33330-2128

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Personalized Medicine Institute Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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