Organization
THE G GENERAL SERV, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL FERNANDEZ GONZALEZ M.D. (MEDICAL DOCTOR)
(786) 261-6935
Entity
Organization
Contact information
Practice address
2140 W FLAGLER ST STE 209, MIAMI, FL 33135-1642
(305) 541-8770
Mailing address
2140 W FLAGLER ST STE 209, MIAMI, FL 33135-1642
(305) 541-8770
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
ME17907
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME17907
STATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE
FL
Enumeration date
11/07/2013
Last updated
11/13/2013
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