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Organization
IBANEZ CLINICAL GROUP LLC
Active
Organization
IBANEZ CLINICAL GROUP LLC
Active
Other names
Ibanez Clinical Group LLC
Organization subpart
No
Provider details
NPI number
Authorized official
GISELLE IBANEZ (MNGR)
(786) 422-4643
Entity
Organization
Contact information
Practice address
1701 PONCE DE LEON BLVD STE 305, CORAL GABLES, FL 33134-4484
(786) 422-4636
Mailing address
1701 PONCE DE LEON BLVD STE 305, CORAL GABLES, FL 33134-4484
(786) 422-4636
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
12/12/2024
Last updated
12/12/2024
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