Provider Demographics
NPI:1427216688
Name:GONZALEZ, ANA M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:M
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:RPH
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 2188
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-2188
Mailing Address - Country:US
Mailing Address - Phone:787-458-4929
Mailing Address - Fax:787-807-7456
Practice Address - Street 1:ROAD 685 KM 2 9 BOTIERRAS NUEVAS
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-2188
Practice Address - Country:US
Practice Address - Phone:787-458-4929
Practice Address - Fax:787-807-7456
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3496183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist