Individual
EDELIO GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1191 W 37TH ST, HIALEAH, FL 33012-4941
(305) 826-9642
(305) 819-8014
Mailing address
1191 W 37TH ST, HIALEAH, FL 33012-4941
(305) 826-9642
(305) 819-8014
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN13074
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871684183
—
FL
Enumeration date
05/22/2014
Last updated
05/22/2014
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