Provider Demographics
NPI:1376675843
Name:GREGORY-GONZALEZ, FEDERICO J (MD)
Entity Type:Individual
Prefix:DR
First Name:FEDERICO
Middle Name:J
Last Name:GREGORY-GONZALEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SAN PATRICIO AVE
Mailing Address - Street 2:SUITE 1050 MARAMAR PLAZA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2715
Mailing Address - Country:US
Mailing Address - Phone:787-946-5220
Mailing Address - Fax:787-946-5220
Practice Address - Street 1:COND MADRESELVA
Practice Address - Street 2:I7 CALLE EBANO APT. 602
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-3100
Practice Address - Country:US
Practice Address - Phone:787-671-6376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14704207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine