Provider Demographics
NPI:1477740678
Name:GONZALEZ, KATE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:MARIE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:MARIE
Other - Last Name:GONZALEZ CANDELARIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:100 COND JARD DE SAN FERNANDO
Mailing Address - Street 2:# 204
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-6973
Mailing Address - Country:US
Mailing Address - Phone:330-554-5377
Mailing Address - Fax:
Practice Address - Street 1:1OO COND JARD DE SAN FERNANDO
Practice Address - Street 2:# 204
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:330-554-5377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16869207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine