Provider Demographics
NPI:1407142300
Name:GONZALEZ, FELIX H (MA)
Entity Type:Individual
Prefix:MR
First Name:FELIX
Middle Name:H
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. EL REAL, CALLE REINA. #416
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-4168
Mailing Address - Country:US
Mailing Address - Phone:787-644-2582
Mailing Address - Fax:
Practice Address - Street 1:CARR, 119, KM 0.0, BO. CAIN BAJO
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4168
Practice Address - Country:US
Practice Address - Phone:787-644-2582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3550103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling