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General NPI Number Information
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NPI Number | 1467262717
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Entity Type | Organization
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Legal Business Name | MEDASANS
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 7100 CAMINO REAL STE 200
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City | BOCA RATON
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State | FL
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Zip | 33433-5510
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Country | US
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Telephone | 754-200-1617
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Fax | 954-656-0108
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Provider Business Mailing Address
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Address Line | 304 INDIAN TRCE # 976
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City | WESTON
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State | FL
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Zip | 33326-2996
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Country | US
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Telephone | 754-200-1617
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | DR. SEGUNDO GONZALEZ
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Credential | MD
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Telephone | 754-200-1617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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