Organization
SAN LAZARGERD MEDICAL II CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALDO GONZALEZ MD (PRESIDENT)
(787) 897-0560
Entity
Organization
Contact information
Practice address
CARR 129 KM 21.2, BO CALLEJONES, LARES, PR 00669
(787) 897-0353
Mailing address
PO BOX 428, LARES, PR 00669-0428
(787) 897-0353
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
PR
2085U0001X
Diagnostic Ultrasound Physician
—
PR
2471S1302X
Sonography Radiologic Technologist
—
PR
2471V0105X
Vascular Sonography Radiologic Technologist
—
PR
Other
Enumeration date
03/08/2018
Last updated
03/08/2018
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