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General NPI Number Information
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NPI Number | 1588957765
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Entity Type | Individual
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Provider Name | MS. ISIDRA GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 05/23/2011
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Last Update Date | 03/30/2025
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Provider Practice Location Address
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Address Line | 2039 BORINQUEN AVE.
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City | SAN JUAN
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State | PR
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Zip | 00915
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Country | US
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Telephone | 787-726-7558
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Fax |
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Provider Business Mailing Address
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Address Line | HC01 BOX 2253 BO. LA PRIETA
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City | COMERIO
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State | PR
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Zip | 00782
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Country | US
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Telephone | 787-423-1350
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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 | 17119
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 7808
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License Number State | PR
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