Provider Demographics
NPI:1912239609
Name:MONREAL GONZALEZ, RICARDO J (SA-C)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:J
Last Name:MONREAL GONZALEZ
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
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Mailing Address - Street 1:6550 N FEDERAL HWY
Mailing Address - Street 2:SUITE 512
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-1404
Mailing Address - Country:US
Mailing Address - Phone:954-267-8777
Mailing Address - Fax:954-772-7801
Practice Address - Street 1:6550 N FEDERAL HWY
Practice Address - Street 2:SUITE 512
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1404
Practice Address - Country:US
Practice Address - Phone:954-267-8777
Practice Address - Fax:954-772-7801
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL09-309246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist