Provider Demographics
NPI:1487651014
Name:GONZALEZ MURIEL, ITZIA (MD)
Entity Type:Individual
Prefix:MRS
First Name:ITZIA
Middle Name:
Last Name:GONZALEZ MURIEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:CALLE 402 MD2
Mailing Address - Street 2:COUNTRY CLUB
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00982
Mailing Address - Country:US
Mailing Address - Phone:787-765-6670
Mailing Address - Fax:787-765-7601
Practice Address - Street 1:MO1 CALLE 413
Practice Address - Street 2:SUITE 201
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-1853
Practice Address - Country:US
Practice Address - Phone:787-765-6670
Practice Address - Fax:787-765-7601
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-28
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR11545207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRPG4557OtherPALIC
PR83943OtherTRIPLES
PR2011051OtherPREFERRED HEALTH CARE
PR9180377OtherHUMANA
PRP270OtherINTERNATIONAL MEDICAL CAR
PR3111545OtherUNION INDEP ACUEDUCTOS
PR500310EOtherMEDICARE MUCHO MAS
PR500310EOtherMEDICARE MUCHO MAS
PRG41191Medicare UPIN