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General NPI Number Information
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NPI Number | 1952418980
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Entity Type | Organization
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Legal Business Name | ALLERGY ASTHMA & SINUS CENTER
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 09/07/2010
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Provider Practice Location Address
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Address Line | 12959 PALMS WEST DRIVE SUITE 230
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City | LOXAHATCHEE
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State | FL
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Zip | 33470
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Country | US
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Telephone | 561-790-2258
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Fax | 561-791-7489
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Provider Business Mailing Address
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Address Line | 12959 PALMS WEST DRIVE SUITE 230
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City | LOXAHATCHEE
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State | FL
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Zip | 33470
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Country | US
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Telephone | 561-790-2258
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Fax | 561-791-7489
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Authorized Official
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Title or Position | PRESIDENT
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Name | GABRIEL E GONZALEZ
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Credential | MD
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Telephone | 561-790-2258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | ME0050008
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License Number State | FL
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