Doctor Name: | DR. JERRY SOLIS-GONZALEZ |
NPI Number: | 1861493561 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 14714 |
Business Practice Address: | Carretera 693 Num. 279 Bo. Brenas Vega Alta, PR - 00692 |
Business Phone Number: | 9396422227 |
Business Fax Number: | 7878834045 |
Mailing Address: | Po Box 1445, TOA BAJA |
State: | PR |
Postal Code: | 009511445 |
Phone Number: | 7875319227 |
Fax Number: | 7878834045 |
NPI Enumeration Date: | 08/03/2005 |
NPI Last Update Date: | 10/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 14714 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |