Provider Demographics
NPI:1467790451
Name:GONZALEZ, JOSUE D (RN)
Entity Type:Individual
Prefix:
First Name:JOSUE
Middle Name:D
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:RN
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 1792
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-1792
Mailing Address - Country:US
Mailing Address - Phone:787-690-4017
Mailing Address - Fax:
Practice Address - Street 1:A 37 DEL RIO
Practice Address - Street 2:CIUDAD JARDIN
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-9820
Practice Address - Country:US
Practice Address - Phone:787-690-4017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR30381163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse