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General NPI Number Information
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NPI Number | 1316268337
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Entity Type | Organization
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Legal Business Name | GASTROINTESTINAL SPECIALISTS OF MIAMI INC
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Dates
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Enumeration Date | 06/14/2010
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Last Update Date | 08/28/2010
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Provider Practice Location Address
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Address Line | 11760 BIRD RD SUITE 642
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City | MIAMI
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State | FL
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Zip | 33175-3582
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Country | US
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Telephone | 305-223-5858
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Fax |
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Provider Business Mailing Address
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Address Line | 11760 BIRD RD SUITE 642
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City | MIAMI
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State | FL
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Zip | 33175-3582
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Country | US
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Telephone | 305-223-5858
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GERMAN GONZALEZ JR.
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Credential | MD
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Telephone | 305-223-5858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME95057
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License Number State | FL
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