Healthcare Provider Details

I. General information

NPI: 1356510424
Provider Name (Legal Business Name): INES GONZALEZ-TORRES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: INES GONZALEZ MD

II. Dates (important events)

Enumeration Date: 02/22/2008
Last Update Date: 02/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 FLOYD CIR
HINESVILLE GA
31313-5536
US

IV. Provider business mailing address

PO BOX 3129
FORT STEWART GA
31315-3129
US

V. Phone/Fax

Practice location:
  • Phone: 912-617-0922
  • Fax: 912-369-0022
Mailing address:
  • Phone: 912-617-0922
  • Fax: 912-369-0022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberH1281
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: