| Doctor Name: | DR. SASHA MARA GONZALEZ |
| NPI Number: | 1750394078 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 15605 |
| Business Practice Address: | Barceloneta Prime Outlets Carr.#2 Km. 54.6 Interseccion Carr. 140 , Bo. Manati Abajo Barceloneta, PR - 00617 |
| Business Phone Number: | 7876071223 |
| Business Fax Number: | 7876264708 |
| Mailing Address: | 425 Carr 693, Pmb #194 DORADO |
| State: | PR |
| Postal Code: | 006464802 |
| Phone Number: | 7875491818 |
| Fax Number: | 7876264708 |
| NPI Enumeration Date: | 08/15/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 15605 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |