Provider Demographics
NPI:1346286408
Name:GONZALEZ, NANETTE L (MD)
Entity Type:Individual
Prefix:
First Name:NANETTE
Middle Name:L
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:URB LAS VEREDAS 169
Mailing Address - Street 2:LAS VEREDAS DE LAS PALMAS
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-9680
Mailing Address - Country:US
Mailing Address - Phone:787-616-7287
Mailing Address - Fax:787-728-5136
Practice Address - Street 1:252 CALLE SAN JORGE
Practice Address - Street 2:SUITE 406 SAN JORGE MEDICAL OFFICE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912-3310
Practice Address - Country:US
Practice Address - Phone:787-726-0210
Practice Address - Fax:787-728-5136
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PR13443208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR20430OtherSSS