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General NPI Number Information
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NPI Number | 1306654157
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Entity Type | Individual
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Provider Name | NIDZALIZ GONZALEZ RAMOS
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Gender | Female
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Dates
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Enumeration Date | 12/26/2024
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | PR 1 AVE. SAKURA, BAIROA, VILLA BLANCA INDUSTRIAL PARK SEGUNDO PISO SUITE 235
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City | CAGUAS
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State | PR
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Zip | 00725
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Country | US
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Telephone | 787-705-5565
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Fax |
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Provider Business Mailing Address
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Address Line | PR6 VIA 19
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City | CAROLINA
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State | PR
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Zip | 00983-4705
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Country | US
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Telephone | 787-587-7590
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 8156
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License Number State | PR
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