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General NPI Number Information
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NPI Number | 1376584821
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Entity Type | Individual
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Provider Name | RUBEN GONZALEZ-VALLINA M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 08/30/2017
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Provider Practice Location Address
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Address Line | 9260 SW 72ND ST 217
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City | MIAMI
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State | FL
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Zip | 33173-3275
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Country | US
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Telephone | 305-271-7330
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Fax | 305-271-4219
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Provider Business Mailing Address
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Address Line | 3100 SW 62ND AVE
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City | MIAMI
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State | FL
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Zip | 33155-3009
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Country | US
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Telephone | 305-271-7330
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Fax | 305-271-4219
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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 | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | ME0055859
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License Number State | FL
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