Individual
JUAN JOSE CANDELARIO GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11531 N 56TH ST, #103, TEMPLE TERRACE, FL 33617-2238
(813) 999-4963
Mailing address
11531 N 56TH ST, #103, TEMPLE TERRACE, FL 33617-2238
(813) 999-4963
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ME130303
FL
390200000X
Student in an Organized Health Care Education/Training Program
28732
PR
390200000X
Student in an Organized Health Care Education/Training Program
29075
PR
Other
Enumeration date
11/04/2011
Last updated
11/04/2016
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