Healthcare Provider Details

I. General information

NPI: 1851068852
Provider Name (Legal Business Name): MRS. AMANDA CRISTINA GONZALEZ LIND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 AVE LAUREL
BAYAMON PR
00956-4816
US

IV. Provider business mailing address

URB BOULEVARD DEL RIO II 500 AVE LOS FILTROS APT. K318
GUAYNABO PR
00969
US

V. Phone/Fax

Practice location:
  • Phone: 787-688-9567
  • Fax:
Mailing address:
  • Phone: 787-688-9567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number37783
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: