Healthcare Provider Details

I. General information

NPI: 1942045422
Provider Name (Legal Business Name): DR. MONICA GONZALEZ ROMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 149 KM 13
CIALES PR
00693
US

IV. Provider business mailing address

PARC PEREZ A1 CALLE A
ARECIBO PR
00612-5490
US

V. Phone/Fax

Practice location:
  • Phone: 787-871-0601
  • Fax:
Mailing address:
  • Phone: 939-250-2901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number24658
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: