Healthcare Provider Details

I. General information

NPI: 1043159205
Provider Name (Legal Business Name): DRA MARIA DE L GONZALEZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 113 KM 2.2 BO GUAYABO
ISABELA PR
00662
US

IV. Provider business mailing address

VISTAS DEL ATLANTICO 110 VISTA HERMOSA
ISABELA PR
00662
US

V. Phone/Fax

Practice location:
  • Phone: 787-479-7522
  • Fax:
Mailing address:
  • Phone: 787-479-7522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIA DE L GONZALEZ
Title or Position: OWNER
Credential: MD
Phone: 787-479-7522