Provider Demographics
NPI:1558414573
Name:MARIA GONZALEZ
Entity Type:Organization
Organization Name:MARIA GONZALEZ
Other - Org Name:FARMACIA MARY, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACISTOWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-735-8723
Mailing Address - Street 1:15 CALLE RAMON FLORES
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-3602
Mailing Address - Country:US
Mailing Address - Phone:787-735-8723
Mailing Address - Fax:787-735-8723
Practice Address - Street 1:15 CALLE RAMON FLORES
Practice Address - Street 2:
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-3602
Practice Address - Country:US
Practice Address - Phone:787-735-8723
Practice Address - Fax:787-735-8723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-21
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2633183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty