=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598803538
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROSALINDA GONZALEZ - TAULL M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/02/2007
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | RADIOLOGIA RCM BOX 29134
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00929-0134
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-777-3535
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8ST.VILLA NEVAREZ 1025
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00927-5214
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-384-9386
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2085R0202X
-----------------------------------------------------
Taxonomy Name | Diagnostic Radiology Physician
-----------------------------------------------------
License Number | 8700
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------