Individual
MR. JORGE GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
6889 NW 179TH ST APT 305, HIALEAH, FL 33015-7465
(305) 718-1417
Mailing address
1581 WEST 48TH ST #108, HIALEAH, FL 33015
(305) 781-1417
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5189262
FL
Other
Enumeration date
10/26/2010
Last updated
10/26/2010
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