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General NPI Number Information
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NPI Number | 1780126672
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Entity Type | Organization
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Legal Business Name | SION MEDICAL CENTER CORP
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Dates
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Enumeration Date | 11/09/2016
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Last Update Date | 11/09/2016
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Provider Practice Location Address
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Address Line | 6447 MIAMI LAKES DR SUITE 222-C
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2741
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Country | US
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Telephone | 786-801-1693
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Fax |
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Provider Business Mailing Address
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Address Line | 6447 MIAMI LAKES DR SUITE 222-C
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2741
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BLANCA NELIDA GONZALEZ
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Credential |
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Telephone | 786-801-1693
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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 | ME106369
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License Number State | FL
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