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General NPI Number Information
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NPI Number | 1023667565
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Entity Type | Individual
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Provider Name | GRETTEL DE LA CARIDAD GONZALEZ GARCIA MD
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Gender | Female
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Dates
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Enumeration Date | 09/07/2019
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 201 LYONS AVE
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City | NEWARK
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State | NJ
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Zip | 07112-2027
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Country | US
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Telephone | 973-926-7425
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Fax |
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Provider Business Mailing Address
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Address Line | 525 W 69TH ST APT 311
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City | HIALEAH
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State | FL
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Zip | 33014-4916
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Country | US
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Telephone | 305-915-6215
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 19-212
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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