Healthcare Provider Details

I. General information

NPI: 1578504833
Provider Name (Legal Business Name): MARIA N. GONZALEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 03/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

K5 VIA LAS ALTURAS LA VISTA URBANIZATION
SAN JUAN PR
00924-4470
US

IV. Provider business mailing address

STREET VIA LAS ALTURAS K5 URB. LA VISTA
SAN JUAN PR
00924
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6887
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: