Healthcare Provider Details

I. General information

NPI: 1366577736
Provider Name (Legal Business Name): NANCY GONZALEZ PH.TEC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR #2 KIL 57.8 CRUSE DAVILA
BARCELONETA PR
00617
US

IV. Provider business mailing address

PO BOX 2008
BARCELONETA PR
00617-2008
US

V. Phone/Fax

Practice location:
  • Phone: 787-846-4412
  • Fax: 787-846-7410
Mailing address:
  • Phone: 787-846-4412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: