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Organization

GT PSYCHIATRY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARIO ROBERTO GONZALEZ M.D. (PRESIDENT)
(787) 800-9959
Entity
Organization

Contact information

Practice address
U3-4 CARR 21, SAN JUAN, PR 00921-3313
(787) 800-9959
Mailing address
PO BOX 363161, SAN JUAN, PR 00936-3161
(787) 800-9959

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
17603
PR
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
17603
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17603
PR LICENCE
PR
Enumeration date
02/08/2016
Last updated
02/08/2016
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