Individual
MS. MIRIAM GONGORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1990 W 56 ST, APT 1203, HIALEAH, FL 33012
(786) 380-6108
Mailing address
1990 W 56TH ST APT 1203, HIALEAH, FL 33012-6918
(786) 380-6108
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
RPT29627
FL
Other
Enumeration date
08/03/2011
Last updated
08/03/2011
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