Healthcare Provider Details

I. General information

NPI: 1447290739
Provider Name (Legal Business Name): ANABIS VERA GONZALEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 03/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

QUEBRADAS WARD KM. 6.2
GUAYANILLA PR
00656-0388
US

IV. Provider business mailing address

PO BOX 560388
GUAYANILLA PR
00656-0388
US

V. Phone/Fax

Practice location:
  • Phone: 787-543-0113
  • Fax:
Mailing address:
  • Phone: 787-543-0113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number8904
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: