Healthcare Provider Details

I. General information

NPI: 1952509481
Provider Name (Legal Business Name): JESSICA GONZALEZ MONTES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. VILLA UNIVERSITARIA CALLE 13 BC-12
HUMACAO PR
00791
US

IV. Provider business mailing address

URB. VILLA UNIVERSITARIA CALLE 13 BC-12
HUMACAO PR
00791
US

V. Phone/Fax

Practice location:
  • Phone: 787-431-5059
  • Fax:
Mailing address:
  • Phone: 787-285-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number17461
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number17461
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: