Provider Demographics
NPI:1275835324
Name:GONZALEZ, MELIXA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELIXA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2568 CALLE DAMASCO
Mailing Address - Street 2:URB. SAN ANTONIO
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-1800
Mailing Address - Country:US
Mailing Address - Phone:787-225-6377
Mailing Address - Fax:
Practice Address - Street 1:2568 CALLE DAMASCO
Practice Address - Street 2:URB. SAN ANTONIO
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-1800
Practice Address - Country:US
Practice Address - Phone:787-225-6377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR53371835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist