Individual
GREGORY CARVAJAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3425 NW 180TH ST, MIAMI GARDENS, FL 33056-3429
(786) 663-3936
Mailing address
3425 NW 180TH ST, MIAMI GARDENS, FL 33056-3429
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
PTA12304
FL
Other
Enumeration date
05/30/2019
Last updated
05/30/2019
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