Healthcare Provider Details

I. General information

NPI: 1770404253
Provider Name (Legal Business Name): QUIDANI XAVIER GONZALEZ MORALES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 1 BOX 5550
SALINAS PR
00751-9728
US

IV. Provider business mailing address

HC 1 BOX 5550
SALINAS PR
00751-9728
US

V. Phone/Fax

Practice location:
  • Phone: 787-316-4273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number25171
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: