Individual provider · NPI-1

Christian Gonzalez, Licensed Dispensing

Technician/Technologist, Optician · Fort Myers, FL

NPI number1306464292
StatusActive
Last updated in NPPESJul 8, 2020

Details

NPI
1306464292
Entity type
Individual (NPI-1)
Name
Christian Gonzalez
Credential
Licensed Dispensing
Sex
Female
Sole proprietor
No
Enumeration date
Jul 8, 2020
Certification date
Jul 8, 2020
Last updated
Jul 8, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156FX1800X Technician/Technologist, OpticianDO7304FLYes

Practice location

4135 Dr Martin Luther King Blvd # G16
Fort Myers, FL 33916-4809

Phone 239-672-4368 · Fax 239-313-5259

Mailing address

4135 Dr Martin Luther King Blvd # G16
Fort Myers, FL 33916-4809

Phone 239-672-4368 · Fax 239-313-5259

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