Provider Demographics
NPI:1558385393
Name:PEDRON-GONZALEZ, IVONE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:IVONE
Middle Name:
Last Name:PEDRON-GONZALEZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5910 SW 93RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1581
Mailing Address - Country:US
Mailing Address - Phone:786-302-2209
Mailing Address - Fax:305-485-1150
Practice Address - Street 1:9740 SW 40TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-4080
Practice Address - Country:US
Practice Address - Phone:305-222-2880
Practice Address - Fax:305-485-1150
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23250183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist