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General NPI Number Information
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NPI Number | 1518079474
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Entity Type | Individual
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Provider Name | YESENIA GONZALEZ MS
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 12/07/2021
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Provider Practice Location Address
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Address Line | AVE ROBERTO CLEMENTE 2716 URB VILLA CAROLINA
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City | CAROLINA
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State | PR
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Zip | 00985
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Country | US
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Telephone | 787-762-3737
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Fax |
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Provider Business Mailing Address
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Address Line | HC 3 BOX 12930
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City | CAROLINA
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State | PR
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Zip | 00987-9607
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Country | US
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Telephone | 787-762-3737
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 586
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License Number State | PR
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