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General NPI Number Information
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NPI Number | 1497292874
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Entity Type | Organization
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Legal Business Name | GONZALEZ PAIN CENTER INC
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Dates
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Enumeration Date | 01/24/2017
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Last Update Date | 01/24/2017
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Provider Practice Location Address
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Address Line | 4800 W FLAGLER ST SUITE 212
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City | CORAL GABLES
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State | FL
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Zip | 33134-1446
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Country | US
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Telephone | 305-381-5550
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Fax | 305-646-1984
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Provider Business Mailing Address
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Address Line | 4800 W FLAGLER ST SUITE 212
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City | CORAL GABLES
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State | FL
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Zip | 33134-1446
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Country | US
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Telephone | 305-381-5550
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Fax | 305-646-1984
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Authorized Official
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Title or Position | OWNER
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Name | JOHANNA GONZALEZ
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Credential |
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Telephone | 305-381-5550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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