Healthcare Provider Details

I. General information

NPI: 1114449022
Provider Name (Legal Business Name): JAVIER ALEJANDRO GONZALEZ COSME MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2017
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1789 PR-21, SUITE 208
SAN JUAN PR
00921-3333
US

IV. Provider business mailing address

PO BOX 9205
ARECIBO PR
00613-9205
US

V. Phone/Fax

Practice location:
  • Phone: 787-952-1227
  • Fax:
Mailing address:
  • Phone: 787-952-1227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberME156003
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number22156
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: