Provider Demographics
NPI:1073714234
Name:ROJAS GONZALEZ, GABRIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:ROJAS GONZALEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 142038
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-2038
Mailing Address - Country:US
Mailing Address - Phone:787-689-5401
Mailing Address - Fax:787-689-5402
Practice Address - Street 1:67 CALLE MARGINAL
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-4202
Practice Address - Country:US
Practice Address - Phone:787-689-5401
Practice Address - Fax:787-689-5402
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR424111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR005-9598Medicare UPIN