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General NPI Number Information
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NPI Number | 1457606444
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Entity Type | Individual
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Provider Name | ALEX N GONZALEZ BOSSOLO M.D
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Gender | Male
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 08/06/2018
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Provider Practice Location Address
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Address Line | 1801 AVE PONCE DE LEON SANTURCE MEDICAL MALL SUIT 308
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City | SAN JUAN
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State | PR
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Zip | 00909
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Country | US
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Telephone | 787-726-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 AVE PONCE DE LEON SANTURCE MEDICAL MALL SUIT 308
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City | SAN JUAN
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State | PR
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Zip | 00909
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Country | US
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Telephone | 787-726-1100
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 19367
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License Number State | PR
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