Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | 18379 | PR |
Y | 208D00000X | General Practice Physician | ACN1014 | FL |
NPI | 1033489042 |
---|---|
Provider Name | Caridad Gonzalez |
First Address | Arecibo, PR 00612-9423 |
Second Address | Kissimmee, FL 34741-3221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2012 |
Last Update Date | 24/05/2021 |