Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 5557 | PR |
NPI | 1043408750 |
---|---|
Provider Name | Dr. Dorabelle Gonzalez |
First Address | Arecibo, PR 00614-4055 |
Second Address | Arecibo, PR 00614-4055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2007 |
Last Update Date | 09/10/2007 |