Provider Demographics
NPI:1518411669
Name:GONZALEZ, ALMA
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 4620
Mailing Address - Street 2:
Mailing Address - City:SABANA HOYOS
Mailing Address - State:PR
Mailing Address - Zip Code:00688-9580
Mailing Address - Country:US
Mailing Address - Phone:787-675-7380
Mailing Address - Fax:
Practice Address - Street 1:HC 2 BOX 4620
Practice Address - Street 2:
Practice Address - City:SABANA HOYOS
Practice Address - State:PR
Practice Address - Zip Code:00688-9580
Practice Address - Country:US
Practice Address - Phone:787-675-7380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-06
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3075183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician