Provider Demographics
NPI:1477245041
Name:GONZALEZ RODRIGUEZ, CARLOS ADOLFO (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ADOLFO
Last Name:GONZALEZ RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BARRIO BOSQUE CALLE CELINA BAEZ SOTOMAYOR 21
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683
Mailing Address - Country:US
Mailing Address - Phone:787-212-6747
Mailing Address - Fax:
Practice Address - Street 1:BARRIO BOSQUE CALLE CELINA BAEZ SOTOMAYOR 21
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-212-6747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23186208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice