Individual
KETTY GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12855 SW 132ND ST, SUITE 207, MIAMI, FL 33186-7207
(786) 587-0424
(786) 250-5094
Mailing address
771 SE 2ND PL, HIALEAH, FL 33010-5405
(305) 801-5996
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/03/2016
Last updated
06/03/2016
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