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General NPI Number Information
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NPI Number | 1396939708
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Entity Type | Individual
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Provider Name | INGRID GONZALEZ M.D
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Gender | Female
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 8 CALLE LUIS MUNOZ MARIN
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City | HORMIGUEROS
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State | PR
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Zip | 00660-1722
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Country | US
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Telephone | 787-849-4302
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Fax | 787-787-8278
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Provider Business Mailing Address
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Address Line | URB VALLE HERMOSO ROSA ST SD1
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City | HORMIGUEROS
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State | PR
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Zip | 00660-1238
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Country | US
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Telephone | 787-833-1266
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Fax | 787-833-1266
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 16825
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License Number State | PR
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