Individual
JOSE RAFAEL GAMBOA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
17877 SW 8TH ST, PEMBROKE PINES, FL 33029-4402
(954) 513-9853
Mailing address
17877 SW 8TH ST, PEMBROKE PINES, FL 33029-4402
(954) 513-9853
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
19-201
FL
Other
Enumeration date
04/20/2019
Last updated
04/20/2019
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