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NPI Code Detail

MEDICARE: MICHELLE GONZALEZ

MEDICARE: MICHELLE GONZALEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist58113FL

General Provider Information

NPI Number : 1912488875
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE GONZALEZ
Provider Business Mailing Address
First Line : 324 NW 134TH CT
Second Line :
City : MIAMI
State : FL
Zip : 33182-1654
Country : US
Telephone Number : 786-812-2115
Fax Number :
Provider Business Practice Location Address
First Line : 1920 WEST AVE
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33139-1434
Country : US
Telephone Number : 305-535-4268
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2018
Last Update Date : 08/28/2018

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Directions to “ MICHELLE GONZALEZ ” Practice Location

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