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General NPI Number Information
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NPI Number | 1447386461
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Entity Type | Individual
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Provider Name | IRAIDA GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | AVE. LOMAS VERDES, EDIF, UNIV. PHOENIX CARRETERA 177,KM.2.0
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City | BAYAMON
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State | PR
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Zip | 00959
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Country | US
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Telephone | 787-272-4998
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Fax | 787-272-4969
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Provider Business Mailing Address
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Address Line | #34 CAMINO LA RIBERAS 3-N 21 COLINAS DEL PLATA
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City | TOA ALTA
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State | PR
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Zip | 00953
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Country | US
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Telephone | 787-524-5344
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 2951
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License Number State | PR
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