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General NPI Number Information
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NPI Number | 1902960685
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Entity Type | Organization
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Legal Business Name | GONZALEZ GROUP ASSOCIATION INC
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9716 SW 24TH ST
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City | MIAMI
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State | FL
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Zip | 33165-7513
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Country | US
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Telephone | 305-480-0037
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Fax | 305-480-0307
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Provider Business Mailing Address
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Address Line | 9716 SW 24TH ST
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City | MIAMI
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State | FL
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Zip | 33165-7513
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Country | US
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Telephone | 305-480-0037
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Fax | 305-480-0307
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Authorized Official
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Title or Position | PRESIDENT
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Name | JESUS GONZALEZ
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Credential |
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Telephone | 786-970-4324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 170100000X
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Taxonomy Name | Ph.D. Medical Genetics
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License Number |
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License Number State |
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