Healthcare Provider Details

I. General information

NPI: 1679850929
Provider Name (Legal Business Name): JOSE ABNER GONZALEZ R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2011
Last Update Date: 11/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE ALMACIGO H27 URB. ARBOLADA
CAGUAS PR
00725
US

IV. Provider business mailing address

CALLE ALMACIGO H27 URB. ARBOLADA
CAGUAS PR
00725-0000
US

V. Phone/Fax

Practice location:
  • Phone: 787-742-0001
  • Fax: 787-742-0176
Mailing address:
  • Phone: 939-940-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2821
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: