Provider Demographics
NPI:1518031285
Name:GONZALEZ MARQUES, MARIA E
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:E
Last Name:GONZALEZ MARQUES
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:E
Other - Last Name:GONZALEZ MARQUES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:URB. EL CONVENTO
Mailing Address - Street 2:CALLE 2, B-30
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683
Mailing Address - Country:US
Mailing Address - Phone:787-892-4286
Mailing Address - Fax:
Practice Address - Street 1:URB. EL CONVENTO CALLE2, B-30
Practice Address - Street 2:CALLE 2, B-30
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-892-4286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR673171100000X
PR15743208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
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PR6210084OtherHUMANA
PR100327Medicare ID - Type UnspecifiedMMM
PRI30239Medicare UPIN