Provider Demographics
NPI:1619634219
Name:ASAP IMMUNIZATION LLC
Entity Type:Organization
Organization Name:ASAP IMMUNIZATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-352-1027
Mailing Address - Street 1:10650 ROE AVE # 119
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66207-3907
Mailing Address - Country:US
Mailing Address - Phone:816-352-1027
Mailing Address - Fax:
Practice Address - Street 1:10650 ROE AVE # 119
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66207-3907
Practice Address - Country:US
Practice Address - Phone:816-352-1027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare