Provider Demographics
NPI: | 1376924506 |
---|---|
Name: | GONZALEZ, ARIEL FRANCISCO (MD) |
Entity Type: | Individual |
Prefix: | |
First Name: | ARIEL |
Middle Name: | FRANCISCO |
Last Name: | 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: | 44 CALLE JAZMIN |
Mailing Address - Street 2: | |
Mailing Address - City: | SAN JUAN |
Mailing Address - State: | PR |
Mailing Address - Zip Code: | 00927-6553 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 787-613-9388 |
Mailing Address - Fax: | |
Practice Address - Street 1: | CENTRO CARDIOVASCULAR PUERTO RICO BO MONACILLOS |
Practice Address - Street 2: | |
Practice Address - City: | SAN JUAN |
Practice Address - State: | PR |
Practice Address - Zip Code: | 00935-0001 |
Practice Address - Country: | US |
Practice Address - Phone: | 787-754-8500 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2015-06-12 |
Last Update Date: | 2022-03-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PR | 34449 | 207R00000X |
PR | 802063100 | 390200000X |
PR | 21837 | 207RC0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |