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General NPI Number Information
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NPI Number | 1043343007
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Entity Type | Individual
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Provider Name | ALEX R GONZALEZ P.T.
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Gender | Male
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 03/18/2019
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Provider Practice Location Address
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Address Line | D18 CALLE MARGINAL URB VILLA REAL
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City | VEGA BAJA
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State | PR
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Zip | 00693-4504
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Country | US
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Telephone | 787-644-3161
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Fax | 787-772-7731
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Provider Business Mailing Address
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Address Line | 140 CALLE ROSA MARIA URB VEGA SERENA
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City | VEGA BAJA
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State | PR
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Zip | 00693-5860
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Country | US
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Telephone | 787-644-3161
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Fax | 787-772-7731
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1122
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License Number State | PR
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