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Organization

GUSTAVO FORTEZA MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GUSTAVO FORTEZA MD (CEO)
(305) 992-7321
Entity
Organization

Contact information

Practice address
10550 NW 77TH CT STE 308, HIALEAH GARDENS, FL 33016-2072
(305) 863-2233
(305) 504-8813
Mailing address
10521 SW 143RD AVE, MIAMI, FL 33186-3035
(305) 889-4978
(305) 504-8813

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
ME85628
FL

Other

Enumeration date
06/29/2012
Last updated
04/29/2022
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