Doctor Name: | MR. RICHARD GONZALEZ |
NPI Number: | 1104028497 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPN/CST/CFA |
License Number: | 103780 |
Business Practice Address: | 3100 E Fletcher Ave Tampa, FL - 336134613 |
Business Phone Number: | 8138179969 |
Business Fax Number: | |
Mailing Address: | 20653 Amanda Oak Ct, LAND O LAKES |
State: | FL |
Postal Code: | 346384335 |
Phone Number: | 8138179969 |
Fax Number: | |
NPI Enumeration Date: | 05/31/2007 |
NPI Last Update Date: | 08/24/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246Z00000X |
License Number: | 103780 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Specialist/Technologist, Other |
Taxonomy Specialization: | |
Taxonomy Definition: | General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |