| Doctor Name: | DR. JORGE LUIS GONZALEZ |
| NPI Number: | 1457368847 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 13834 |
| Business Practice Address: | Carr. 455 Int454 Km. 2.3 Camuy, PR - 00627 |
| Business Phone Number: | 7872627537 |
| Business Fax Number: | 7878847463 |
| Mailing Address: | P.o. Box 803, MANATI |
| State: | PR |
| Postal Code: | 00674 |
| Phone Number: | 7872627537 |
| Fax Number: | 7878847463 |
| NPI Enumeration Date: | 08/01/2006 |
| NPI Last Update Date: | 11/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 13834 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |