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General NPI Number Information
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NPI Number | 1710231444
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Entity Type | Individual
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Provider Name | MARIBELLA GONZALEZ-VIRUET PHD
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Gender | Female
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Dates
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Enumeration Date | 11/02/2012
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 1788 CALLE JULIO AYBAR
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City | SAN JUAN
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State | PR
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Zip | 00921-4410
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Country | US
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Telephone | 787-638-3520
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Fax |
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Provider Business Mailing Address
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Address Line | 3011 ALEJADRINO AVE COND. VIEW POINT APT 504
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone | 787-638-3520
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2114
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 2114
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License Number State | PR
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