Individual
LISDAN GONZALEZ SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
777 NW 72ND AVE STE 3072, MIAMI, FL 33126-3188
(305) 396-3862
(305) 396-8526
Mailing address
777 NW 72ND AVE STE 3072, MIAMI, FL 33126-3188
(305) 396-3862
(305) 396-8526
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
HCC11651
FL
225700000X
Massage Therapist
Primary
HCC11651
FL
Other
Enumeration date
02/25/2019
Last updated
02/25/2019
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