Individual
VIRGINIA YAJAIRA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
402 MCMILLAN ROAD, WEST MONROE, LA 71291-5326
(318) 338-3540
(318) 335-3542
Mailing address
1868 FORSYTHE AVE STE 333 PMB, MONROE, LA 71201-3540
(318) 338-3540
(318) 335-3542
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
11314R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1667781
—
LA
Enumeration date
10/21/2006
Last updated
03/27/2012
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