Doctor Name: | DR. LUIS GONZALEZ |
NPI Number: | 1730337155 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 17,313 |
Business Practice Address: | 1540 Spring Valley Dr Huntington, WV - 257049300 |
Business Phone Number: | 3044296741 |
Business Fax Number: | |
Mailing Address: | Calle San Isidro #o-1 Urb. Mariolga, CAGUAS |
State: | PR |
Postal Code: | 00725 |
Phone Number: | 9392185277 |
Fax Number: | 7877441059 |
NPI Enumeration Date: | 08/28/2008 |
NPI Last Update Date: | 02/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 17,313 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |