Healthcare Provider Details

I. General information

NPI: 1952199341
Provider Name (Legal Business Name): MIGUEL ANGEL GONZALEZ UGARTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO MEDICO PUERTO RICO
SAN JUAN PR
00935-0001
US

IV. Provider business mailing address

HC 7 BOX 39249
AGUADILLA PR
00603-9439
US

V. Phone/Fax

Practice location:
  • Phone: 787-777-3535
  • Fax:
Mailing address:
  • Phone: 787-246-6242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number18007
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: