Provider Demographics
NPI:1144249095
Name:GONZALEZ, ANA INES (MD)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:INES
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:300 AVE LA SIERRA
Mailing Address - Street 2:BOX 203
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4330
Mailing Address - Country:US
Mailing Address - Phone:787-382-9717
Mailing Address - Fax:
Practice Address - Street 1:715 AVE. PONCE DE LEON PDA. 37
Practice Address - Street 2:HOSPITAL AUXILIO MUTUO
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-653-0505
Practice Address - Fax:787-286-7572
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2008-12-10
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Provider Licenses
StateLicense IDTaxonomies
PR130182085P0229X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH42445Medicare UPIN