Most Relevant Information
Provider Data
| NPI Number: | 1003480658 |
| Provider Name: | LILIBET MIRANDA GONZALEZ MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/18/2021 |
| Last Updated: | 05/18/2021 |
Provider Practice Location
715 AVE PONCE DE LEON
HATO REY
PR
009175032
Practice Location Phone/Fax
| Phone: | 7877580000 |
| Fax: |
Provider Mailing Location
1561 KUDZA RD
WEST PALM BEACH
FL
334155520
Provider Mailing Phone/Fax
| Phone: | 5613854933 |
| Fax: |