Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 10686 | PR |
N | 208000000X | Pediatrician | 10686 | PR |
NPI | 1104895317 |
---|---|
Provider Name | Dr. Alfredo A Gonzalez |
First Address | Guaynabo, PR 00970-3916 |
Second Address | San Juan, PR 00907-1511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 08/07/2007 |