Provider Demographics
NPI:1114984697
Name:GONZALEZ, RAMON H (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:H
Last Name:GONZALEZ
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 1:267 SIERRA MORENA STREET
Mailing Address - Street 2:URB LA CUMBRE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-649-1024
Mailing Address - Fax:
Practice Address - Street 1:267 CALLE SIERRA MORENA
Practice Address - Street 2:URB LA CUMBRE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5574
Practice Address - Country:US
Practice Address - Phone:787-649-1024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12544207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG49560Medicare UPIN
PR89039Medicare ID - Type Unspecified