Healthcare Provider Details

I. General information

NPI: 1316753114
Provider Name (Legal Business Name): YOEL GONZALEZ GUERRA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2024
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7530 NW 10TH AVE
MIAMI FL
33150-3323
US

IV. Provider business mailing address

7530 NW 10TH AVE
MIAMI FL
33150-3323
US

V. Phone/Fax

Practice location:
  • Phone: 239-367-6232
  • Fax:
Mailing address:
  • Phone: 239-367-6232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: