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NPI 1043852296

NPI 1043852296 : ANTHONY GONZALEZ SANTANA MSW : SANTA ISABEL, PR

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General NPI Number Information
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    NPI Number           |    1043852296
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    Entity Type          |    Individual 
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    Provider Name        |    ANTHONY GONZALEZ SANTANA MSW
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/09/2019
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    Last Update Date     |    04/08/2021
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Provider Practice Location Address
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    Address Line         |    CALLE BETANCES #14 
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    City                 |    SANTA ISABEL
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    State                |    PR
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    Zip                  |    00757
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    Country              |    US
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    Telephone            |    787-845-6000
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    Fax                  |    787-946-0207
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Provider Business Mailing Address
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    Address Line         |    HC 2 BOX 7836 
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    City                 |    SANTA ISABEL
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    State                |    PR
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    Zip                  |    00757-9763
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    Country              |    US
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    Telephone            |    787-459-3522
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    15151
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    License Number State |    PR
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