Doctor Name: | DR. ELBA ROSA GONZALEZ BAUZA |
NPI Number: | 1821291212 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 5254 |
Business Practice Address: | Miramar Km 78.7 Carreters Ertalal # 2 Corp Del Fondo Del Seguro Del Estado Avenida Arecibo, PR - 006144055 |
Business Phone Number: | 7878785757 |
Business Fax Number: | 7878173757 |
Mailing Address: | Po Box 16, LARES |
State: | PR |
Postal Code: | 00669 |
Phone Number: | 7878965653 |
Fax Number: | |
NPI Enumeration Date: | 06/06/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 5254 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |