Healthcare Provider Details

I. General information

NPI: 1801100532
Provider Name (Legal Business Name): MARGARITA PEREZ DE GONZALEZ LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2010
Last Update Date: 08/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 NW 7TH ST STE 202
MIAMI FL
33126-2941
US

IV. Provider business mailing address

6301 SW 24TH ST
MIAMI FL
33155-1928
US

V. Phone/Fax

Practice location:
  • Phone: 305-262-7052
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License NumberMA28577
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: