Healthcare Provider Details

I. General information

NPI: 1427216688
Provider Name (Legal Business Name): ANA M GONZALEZ RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2008
Last Update Date: 05/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROAD 685 KM 2 9 BOTIERRAS NUEVAS
MANATI PR
00674-2188
US

IV. Provider business mailing address

PO BOX 2188
MANATI PR
00674-2188
US

V. Phone/Fax

Practice location:
  • Phone: 787-458-4929
  • Fax: 787-807-7456
Mailing address:
  • Phone: 787-458-4929
  • Fax: 787-807-7456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3496
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: