Individual
CHRISTIAN GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED DISPENSING
Contact information
Practice address
4135 DR MARTIN LUTHER KING BLVD # G16, FORT MYERS, FL 33916-4809
(239) 672-4368
(239) 313-5259
Mailing address
4135 DR MARTIN LUTHER KING BLVD # G16, FORT MYERS, FL 33916-4809
(239) 672-4368
(239) 313-5259
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO7304
FL
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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