Healthcare Provider Details

I. General information

NPI: 1962860429
Provider Name (Legal Business Name): SACHA CRISTIN MARRIE GONZALEZ AVILES M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2016
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 CALLE JOSE CELSO BARBOSA S
CAYEY PR
00736-4726
US

IV. Provider business mailing address

91 CALLE#1 URB TERRA DEL MONTE
CAYEY PR
00736
US

V. Phone/Fax

Practice location:
  • Phone: 787-738-3088
  • Fax: 787-738-0551
Mailing address:
  • Phone: 787-455-0321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19209
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: