Organization
BTW PROVIDERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS ENRIQUE GONZALEZ JR. (PRESIDENT)
(786) 507-1600
Entity
Organization
Contact information
Practice address
8080 NW 155TH ST, HIALEAH, FL 33016-5880
(786) 507-1600
(786) 507-1610
Mailing address
8080 NW 155TH ST, HIALEAH, FL 33016-5880
(786) 507-1600
(786) 507-1610
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
HCC7163
FL
Other
Enumeration date
05/01/2007
Last updated
08/22/2020
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