Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 13275 | PR |
NPI | 1053304279 |
---|---|
Provider Name | Omayra L Gonzalez |
First Address | Guaynabo, PR 00969-5374 |
Second Address | San Juan, PR 00936 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 21/05/2020 |