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Organization

SAN LAZARGERD MEDICAL II CSP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GERALDO GONZALEZ M.D. (PRESIDENT)
(787) 897-0353
Entity
Organization

Contact information

Practice address
CARR. 129 KM 21.2, LARES, PR 00669-0000
(787) 897-0353
(787) 897-3979
Mailing address
PO BOX 428, LARES, PR 00669-0428
(787) 897-0353
(787) 897-3979

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
13643
PR
261QM1300X
Multi-Specialty Clinic/Center

Other

Enumeration date
05/02/2014
Last updated
10/16/2015
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