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General NPI Number Information
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NPI Number | 1952391336
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Entity Type | Individual
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Provider Name | JUAN GONZALEZ DIAZ MD
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Gender | Male
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 03/25/2011
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Provider Practice Location Address
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Address Line | LOCAL AA 5 LOIZA VALLEY SHOPPING CENTER LOIZA VALLEY
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City | CANOVANAS
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State | PR
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Zip | 00729
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Country | US
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Telephone | 787-886-5506
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Fax | 787-876-4116
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Provider Business Mailing Address
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Address Line | 267 CALLE SIERRA MORENA PMB #330
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City | SAN JUAN
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State | PR
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Zip | 00926-5539
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Country | US
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Telephone | 787-886-5506
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Fax | 787-876-4116
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 07130
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License Number State | PR
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