Individual
MARIO GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
111 S 11TH ST STE G8490, PHILADELPHIA, PA 19107
(215) 955-6161
Mailing address
111 S 11TH ST STE G8490, PHILADELPHIA, PA 19107-4824
(215) 955-1120
(215) 255-3577
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS013709
PA
Other
Enumeration date
09/06/2006
Last updated
10/21/2019
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