Provider Demographics
NPI:1437253952
Name:GONZALEZ MARTINEZ, REINALDO (MD FCCP)
Entity Type:Individual
Prefix:MR
First Name:REINALDO
Middle Name:
Last Name:GONZALEZ MARTINEZ
Suffix:
Gender:M
Credentials:MD FCCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE JILGUERO 276
Mailing Address - Street 2:URB MONTEHIEDRA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-785-3923
Mailing Address - Fax:787-780-4872
Practice Address - Street 1:CALLE SANTA CRUZ #68 EDIF TORRE SAN PABLO
Practice Address - Street 2:SUITE 303
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-785-3923
Practice Address - Fax:787-780-4872
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11018207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
G37211Medicare UPIN
88670Medicare ID - Type Unspecified