Healthcare Provider Details

I. General information

NPI: 1518943877
Provider Name (Legal Business Name): GERMAN GONZALEZ-YANES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 AVE FD ROOSEVELT SUITE 811 LA TORRE DE PLAZA
SAN JUAN PR
00918-8001
US

IV. Provider business mailing address

525 AVE FD ROOSEVELT SUITE 811 LA TORRE DE PLAZA
SAN JUAN PR
00918-8001
US

V. Phone/Fax

Practice location:
  • Phone: 787-759-8465
  • Fax: 787-282-4026
Mailing address:
  • Phone: 787-759-8465
  • Fax: 787-282-4026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number9649
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: