Healthcare Provider Details

I. General information

NPI: 1407760275
Provider Name (Legal Business Name): MARIA DEL CARMEN GONZALEZ HERNANDEZ RDMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11044 MONTE BELLO
VILLALBA PR
00766-2357
US

IV. Provider business mailing address

11044 MONTE BELLO
VILLALBA PR
00766-2357
US

V. Phone/Fax

Practice location:
  • Phone: 787-360-9070
  • Fax:
Mailing address:
  • Phone: 787-360-9070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number1363
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: