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General NPI Number Information
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NPI Number | 1295468247
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Entity Type | Organization
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Legal Business Name | GASTON MEDICAL CENTER CORP
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Dates
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Enumeration Date | 07/07/2022
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 6500 COW PEN RD STE 201
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City | MIAMI LAKES
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State | FL
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Zip | 33014-7620
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Country | US
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Telephone | 786-518-3907
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Fax | 786-980-3907
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Provider Business Mailing Address
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Address Line | 6500 COW PEN RD STE 201
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City | MIAMI LAKES
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State | FL
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Zip | 33014-7620
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Country | US
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Telephone | 786-518-3907
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Fax | 786-980-3907
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEXIS RODRIGUEZ
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Credential |
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Telephone | 786-518-3907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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