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General NPI Number Information
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NPI Number | 1467935700
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Entity Type | Individual
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Provider Name | MICHELLE LINARIS LORENZO GONZALEZ MD
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Gender | Female
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Dates
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Enumeration Date | 09/12/2018
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | CARR 411 KM 5.9
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City | AGUADA
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State | PR
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Zip | 00602-0060
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Country | US
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Telephone | 939-286-7050
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Fax |
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Provider Business Mailing Address
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Address Line | HC 60 BOX 15262
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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 | 939-286-7050
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14406
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 004115
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License Number State | PR
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