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General NPI Number Information
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NPI Number | 1790206308
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Entity Type | Organization
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Legal Business Name | GERARDO GONZALEZ MD PA
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Dates
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Enumeration Date | 07/05/2017
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Last Update Date | 07/05/2017
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Provider Practice Location Address
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Address Line | 2387 W 68TH ST STE 304
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City | HIALEAH
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State | FL
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Zip | 33016-6890
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Country | US
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Telephone | 305-824-3604
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Fax |
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Provider Business Mailing Address
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Address Line | 2387 W 68TH ST STE 304
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City | HIALEAH
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State | FL
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Zip | 33016-6890
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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 | MD/PRESIDENT
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Name | GERARDO GONZALEZ
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Credential |
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Telephone | 305-824-3604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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