Healthcare Provider Details

I. General information

NPI: 1114868668
Provider Name (Legal Business Name): RICARDO RODRIGUEZ GONZALEZ MSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URBANIZACION LAS QUINTAS DEL REY 194 CALLE ESPANA
SAN GERMAN PR
00683
US

IV. Provider business mailing address

URBANIZACION LAS QUINTAS DEL REY 194 CALLE ESPANA
SAN GERMAN PR
00683
US

V. Phone/Fax

Practice location:
  • Phone: 787-910-0952
  • Fax:
Mailing address:
  • Phone: 787-910-0952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number4342E
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: