Organization
IQ CORPORATION, P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADOLFO GONZALEZ SAC (MD GENERAL PRACTICE)
(787) 241-6256
Entity
Organization
Contact information
Practice address
15 CALLE DR BASORA N, MAYAGUEZ, PR 00680-4833
(787) 241-6256
Mailing address
URB LA RIVIERA, CONDOMINIO MEDICAL CENTER PLAZE APT 307, RIO PIEDRAS, PR 00921-0000
(787) 241-6256
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
90248
PTAN MEDICARE
PR
Enumeration date
01/18/2013
Last updated
10/11/2013
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