Individual
GERALDO GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
CARR 129 KM 21.2, LARES, PR 00669-0916
(787) 897-0560
Mailing address
PO BOX 916, LARES, PR 00669-0916
(787) 897-0560
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
13643
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100105W
MMM
—
01
—
1105A
PMC
—
01
—
20634
TS
—
01
—
6606242211
MCS
—
Enumeration date
12/01/2006
Last updated
10/16/2015
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