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General NPI Number Information
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NPI Number | 1891359329
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Entity Type | Organization
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Legal Business Name | DRA DAMARYS GONZALEZ GALICIA PSC
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Dates
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Enumeration Date | 04/30/2019
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Last Update Date | 04/30/2019
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Provider Practice Location Address
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Address Line | CARR 417 KM 4.2 BO MAMEY
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City | AGUADA
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State | PR
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Zip | 00602-0060
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Country | US
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Telephone | 787-477-0342
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Fax | 787-658-6102
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Provider Business Mailing Address
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Address Line | PO BOX 1586
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City | AGUADA
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State | PR
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Zip | 00602-1586
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Country | US
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Telephone | 787-477-0342
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Fax | 787-658-6102
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. DAMARYS GONZALEZ
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Credential | MD
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Telephone | 787-477-0342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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