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General NPI Number Information
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NPI Number | 1689277584
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Entity Type | Individual
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Provider Name | MICHELLE GAIL GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 11/21/2020
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Last Update Date | 11/21/2020
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Provider Practice Location Address
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Address Line | 9990 BELVEDERE RD
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-3518
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Country | US
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Telephone | 561-795-0135
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Fax |
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Provider Business Mailing Address
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Address Line | 15781 CEDAR GROVE LN
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City | WELLINGTON
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State | FL
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Zip | 33414-6312
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Country | US
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Telephone | 561-758-2789
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 27617
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License Number State | FL
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