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General NPI Number Information
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NPI Number | 1942897830
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Entity Type | Individual
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Provider Name | WILFREDO GONZALEZ-TRINIDAD PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/25/2020
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Last Update Date | 12/25/2020
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Provider Practice Location Address
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Address Line | 2929 W VALENCIA RD
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City | TUCSON
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State | AZ
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Zip | 85746-8036
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Country | US
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Telephone | 520-578-0138
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Fax |
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Provider Business Mailing Address
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Address Line | 2410 S MISSION RD APT 16107
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City | TUCSON
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State | AZ
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Zip | 85713-3141
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Country | US
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Telephone | 787-308-6677
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S024990
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License Number State | AZ
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