Individual
CHRISTIAN JADIEL GONZALEZ HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 S ANDREWS AVE, FORT LAUDERDALE, FL 33316-2510
(954) 355-4400
Mailing address
1600 S ANDREWS AVE, FORT LAUDERDALE, FL 33316-2510
(954) 355-4400
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PSI36085
FL
Other
Enumeration date
04/09/2020
Last updated
04/09/2020
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