Provider Demographics
NPI:1326193582
Name:ARCE GONZALEZ, RAQUEL (PHL)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:ARCE GONZALEZ
Suffix:
Gender:F
Credentials:PHL
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 364189
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4189
Mailing Address - Country:US
Mailing Address - Phone:787-767-6710
Mailing Address - Fax:787-758-0950
Practice Address - Street 1:URB PEREZ MORRIS
Practice Address - Street 2:CALLE BAEZ # 500
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00917
Practice Address - Country:US
Practice Address - Phone:787-767-6710
Practice Address - Fax:787-758-0950
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR957235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist