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General NPI Number Information
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NPI Number | 1104608827
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Entity Type | Individual
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Provider Name | BETHEL MARIE GONZALEZ MD
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Gender | Female
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Dates
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Enumeration Date | 10/17/2023
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | TURABO GARDENS CARR.172 SALIDA 21 TURABO GARDENS CARR.172 SALIDA 21
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City | CAGUAS
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State | PR
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Zip | 00727-7084
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Country | US
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Telephone | 787-653-0550
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Fax |
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Provider Business Mailing Address
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Address Line | RR 7 BOX 6710
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City | SAN JUAN
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State | PR
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Zip | 00926-9121
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Country | US
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Telephone |
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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 | 16595
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License Number State | PR
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