Provider Demographics
NPI:1295219483
Name:GONZALEZ GARCIA, STEPHANIE MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:MICHELLE
Last Name:GONZALEZ GARCIA
Suffix:
Gender:F
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:PO BOX 367976
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-7976
Mailing Address - Country:US
Mailing Address - Phone:787-454-2105
Mailing Address - Fax:
Practice Address - Street 1:1449 CALLE AMERICO SALAS STE 201
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-2101
Practice Address - Country:US
Practice Address - Phone:787-724-4433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2023-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23190207V00000X
PR34603R207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology