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General NPI Number Information
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NPI Number | 1508465972
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Entity Type | Individual
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Provider Name | JAVIER ORLANDO GONZALEZ
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Gender | Male
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Dates
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Enumeration Date | 10/18/2020
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 1206 CALLE 62 SE
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City | SAN JUAN
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State | PR
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Zip | 00921-3134
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Country | US
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Telephone | 787-297-3244
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Fax |
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Provider Business Mailing Address
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Address Line | 1206 CALLE 62 SE
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City | SAN JUAN
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State | PR
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Zip | 00921-3134
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Country | US
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Telephone | 787-297-3244
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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 | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 2666
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License Number State | PR
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