Provider Demographics
NPI:1184714552
Name:GONZALEZ, HANSEL (PHARMD)
Entity type:Individual
Prefix:
First Name:HANSEL
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 E 26TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3408
Mailing Address - Country:US
Mailing Address - Phone:786-285-9902
Mailing Address - Fax:305-863-3340
Practice Address - Street 1:1201 E 10TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3700
Practice Address - Country:US
Practice Address - Phone:305-863-3338
Practice Address - Fax:305-863-3340
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40096183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist