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General NPI Number Information
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NPI Number | 1255607222
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Entity Type | Individual
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Provider Name | NOELANI GONZALEZ ORTIZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/23/2012
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 525 AVE FD ROOSEVELT STE 409 TORRE DE PLAZA
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City | SAN JUAN
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State | PR
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Zip | 00918-8081
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Country | US
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Telephone | 787-473-0073
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Fax |
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Provider Business Mailing Address
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Address Line | 120 AVE CARLOS CHARDON STE 133
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City | SAN JUAN
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State | PR
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Zip | 00918-1721
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Country | US
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Telephone | 787-505-9160
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 021269
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License Number State | PR
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