Provider Demographics
NPI:1437834645
Name:GONZALEZ ESPADA, LISA VICTORIA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:VICTORIA
Last Name:GONZALEZ ESPADA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3B6 CALLE BORGONA, VILLA DEL REY 3
Mailing Address - Street 2:APT. B-2
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:787-327-8656
Mailing Address - Fax:
Practice Address - Street 1:3B6 CALLE BORGONA, VILLA DEL REY 3
Practice Address - Street 2:APT. B-2
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727
Practice Address - Country:US
Practice Address - Phone:787-327-8656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program