Organization
GASTON MEDICAL CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS RODRIGUEZ (PRESIDENT)
(786) 518-3907
Entity
Organization
Contact information
Practice address
6500 COW PEN RD STE 201, MIAMI LAKES, FL 33014-7620
(786) 518-3907
(786) 980-3907
Mailing address
6500 COW PEN RD STE 201, MIAMI LAKES, FL 33014-7620
(786) 518-3907
(786) 980-3907
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
861729510
12709
FL
Enumeration date
07/07/2022
Last updated
01/04/2023
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