Organization
IBANEZ CLINICAL GROUP LLC
Active
Other names
Ibanez Clinical Group LLC
Organization subpart
No
Provider details
NPI number
Authorized official
GISELLE IBANEZ (MNGR)
(786) 422-4643
Entity
Organization
Contact information
Practice address
1701 PONCE DE LEON BLVD STE 305, CORAL GABLES, FL 33134-4484
(786) 422-4636
Mailing address
1701 PONCE DE LEON BLVD STE 305, CORAL GABLES, FL 33134-4484
(786) 422-4636
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
12/12/2024
Last updated
12/12/2024
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