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General NPI Number Information
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NPI Number | 1376727560
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Entity Type | Individual
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Provider Name | DAMARYS GONZALEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | CARR. 417 KM 4.2 BO. MAMEY
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City | AGUADA
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State | PR
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Zip | 00602
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Country | US
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Telephone | 787-477-0342
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Fax | 787-658-6102
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Provider Business Mailing Address
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Address Line | PO BOX 1586
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City | AGUADA
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State | PR
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Zip | 00602-1586
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Country | US
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Telephone | 787-477-0342
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Fax | 787-658-6102
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 16974
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 16974
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License Number State | PR
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