Provider Demographics
NPI:1558784793
Name:GONZALEZ, CARMEN C (RN MSN)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:C
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:RN MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PASEO SAN PABLO 100 STE 204
Mailing Address - Street 2:EDIFICIO ARTURO CADILLA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-740-2925
Mailing Address - Fax:787-786-4667
Practice Address - Street 1:PASEO SAN PABLO 100 STE 204
Practice Address - Street 2:EDIFICIO ARTURO CADILLA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-9998
Practice Address - Country:US
Practice Address - Phone:787-740-2925
Practice Address - Fax:787-786-4667
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1230163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2233715OtherLICENCIA
PR25761OtherLICENCIA ENFERMERIA