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General NPI Number Information
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NPI Number | 1104173442
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Entity Type | Individual
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Provider Name | CARMEN ARLENE GONZALEZ PSY. D
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Gender | Female
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Dates
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Enumeration Date | 08/06/2012
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 509 STREET OU20 COUNTRY CLUB
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City | CAROLINA
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State | PR
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Zip | 00982-1901
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Country | US
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Telephone | 787-590-5101
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Fax |
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Provider Business Mailing Address
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Address Line | 213 PARK TREE TER APT 822
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City | ORLANDO
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State | FL
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Zip | 32825-3465
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Country | US
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Telephone | 321-695-0835
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4273
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0
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License Number State | FL
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