Individual
JOHANNIE GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
BO BAYANEY CARR 129 KM 13.6, HATILLO, PR 00659-0000
(787) 317-7129
Mailing address
HC 3 BOX 20416, ARECIBO, PR 00612-8126
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
019369
PR
Other
Enumeration date
10/24/2016
Last updated
01/04/2021
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