Provider Demographics
NPI:1083945661
Name:GONZALEZ ROMERO, GILMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:GILMAR
Middle Name:
Last Name:GONZALEZ ROMERO
Suffix:
Gender:M
Credentials:MD
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 1953
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-1953
Mailing Address - Country:US
Mailing Address - Phone:787-236-7844
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 111 KM.2.4
Practice Address - Street 2:BARRIO PALMAR
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-9998
Practice Address - Country:US
Practice Address - Phone:787-551-4051
Practice Address - Fax:787-551-4052
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17754207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HW138AOtherPTAN