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Organization
GONZALO J IRAVEDRA PA
Active
Organization
GONZALO J IRAVEDRA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GONZALO J IRAVEDRA MD (PRESIDENT)
(954) 499-7878
Entity
Organization
Contact information
Practice address
18503 PINES BLVD, SUITE 303, PEMBROKE PINES, FL 33029-1404
(954) 499-7878
(954) 499-7877
Mailing address
18503 PINES BLVD, SUITE 303, PEMBROKE PINES, FL 33029-1404
(954) 499-7878
(954) 499-7877
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME32736
FL
Other
Enumeration date
07/29/2006
Last updated
06/19/2008
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