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General NPI Number Information
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NPI Number | 1235953191
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Entity Type | Individual
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Provider Name | PABLO CRUZ GONZALVEZ RDH
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Gender | Male
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 162 N POWERLINE RD
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City | POMPANO BEACH
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State | FL
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Zip | 33069-2514
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Country | US
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Telephone | 954-970-7067
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Fax | 954-966-3320
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Provider Business Mailing Address
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Address Line | 162 N POWERLINE RD
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City | POMPANO BEACH
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State | FL
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Zip | 33069-2514
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Country | US
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Telephone | 954-970-7067
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Fax | 954-966-3320
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH32941
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License Number State | FL
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