Provider Demographics
NPI:1235332495
Name:GONZALEZ, LUZ DELIA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:LUZ
Middle Name:DELIA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND LOS NARANJALES
Mailing Address - Street 2:PO BOX 607 PMB 156
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-5877
Mailing Address - Country:US
Mailing Address - Phone:787-758-8079
Mailing Address - Fax:
Practice Address - Street 1:TENIENTE CESAR GONZALEZ
Practice Address - Street 2:VILLA NEVARES1106
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00928
Practice Address - Country:US
Practice Address - Phone:787-758-8019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR28165164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse