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Individual

MR. PABLO GONZALEZ SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MASSAGE THERAPY

Contact information

Practice address
2613 SW 143RD AVE, MIAMI, FL 33175-6583
(786) 444-6695
Mailing address
2613 SW 143RD AVE, MIAMI, FL 33175-6583
(786) 444-6695

Taxonomy

Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
MA64616
FL

Other

Enumeration date
10/14/2011
Last updated
10/14/2011
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