Individual
JORGE LUIS GONZALEZ MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4422 3RD AVE, BRONX, NY 10457-2545
(718) 960-9000
Mailing address
13224 POENER PL, HERNDON, VA 20170-4336
(703) 231-2250
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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