Provider Demographics
NPI:1114635216
Name:REINALDO GONZALEZ MARTINEZ, LLC
Entity Type:Organization
Organization Name:REINALDO GONZALEZ MARTINEZ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REINALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-785-3923
Mailing Address - Street 1:276 CALLE JILGUERO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7109
Mailing Address - Country:US
Mailing Address - Phone:787-785-3923
Mailing Address - Fax:787-780-4872
Practice Address - Street 1:#68 CALLE SANTA CRUZ
Practice Address - Street 2:EDIF TORRE SAN PABLO OFIC 303
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-785-3923
Practice Address - Fax:787-780-4872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty