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General NPI Number Information
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NPI Number | 1841913795
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Entity Type | Individual
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Provider Name | PEDRO GONZALEZ
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Gender | Male
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Dates
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Enumeration Date | 09/23/2022
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Last Update Date | 09/23/2022
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Provider Practice Location Address
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Address Line | 8720 W FLAGLER ST
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City | MIAMI
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State | FL
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Zip | 33174-2404
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Country | US
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Telephone | 305-220-1121
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Fax |
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Provider Business Mailing Address
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Address Line | 17911 SW 137TH CT
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City | MIAMI
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State | FL
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Zip | 33177-6415
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Country | US
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Telephone | 786-498-6039
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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 | PS63663
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License Number State | FL
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