Provider Demographics
NPI:1114072287
Name:ALEJANDRO GONZALEZ, LUIS (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:LUIS
Middle Name:
Last Name:ALEJANDRO GONZALEZ
Suffix:
Gender:M
Credentials:PHARMACIST
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 1729
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-1729
Mailing Address - Country:US
Mailing Address - Phone:787-272-5231
Mailing Address - Fax:
Practice Address - Street 1:142 CALLE CARAZO
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-6408
Practice Address - Country:US
Practice Address - Phone:787-720-2934
Practice Address - Fax:787-789-2920
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1721183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist