Provider Demographics
NPI:1235992884
Name:GONZALEZ, ROUS MADAI
Entity Type:Individual
Prefix:
First Name:ROUS
Middle Name:MADAI
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB VILLA SERENA
Mailing Address - Street 2:CALLE JAZMIN O-16
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-553-0690
Mailing Address - Fax:
Practice Address - Street 1:URB VILLA SERENA
Practice Address - Street 2:CALLE JAZMIN O-16
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-553-0690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program