Healthcare Provider Details

I. General information

NPI: 1033025861
Provider Name (Legal Business Name): NORMAN GONZALEZ CASIANO CSP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 117 KM 5.4 BO LAJAS ARRIBA
LAJAS PR
00667
US

IV. Provider business mailing address

PO BOX 713
YAUCO PR
00698-0713
US

V. Phone/Fax

Practice location:
  • Phone: 787-804-3359
  • Fax: 787-804-4137
Mailing address:
  • Phone: 787-804-3359
  • Fax: 787-804-4137

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: NORMAN GONZALEZ CASIANO
Title or Position: PRESIDENT
Credential: MD
Phone: 787-804-3359