Provider Demographics
NPI:1588604839
Name:GONZALEZ GARCIA, MANUEL MIGUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:MIGUEL
Last Name:GONZALEZ GARCIA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:B1 CALLE SANTA CRUZ
Mailing Address - Street 2:CARIMED PLAZA SUITE 506
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-6933
Mailing Address - Country:US
Mailing Address - Phone:787-785-3687
Mailing Address - Fax:787-995-0201
Practice Address - Street 1:B1 CALLE SANTA CRUZ
Practice Address - Street 2:CARIMED PLAZA SUITE 506
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6933
Practice Address - Country:US
Practice Address - Phone:787-785-3687
Practice Address - Fax:787-995-0201
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR11844207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH26456Medicare UPIN
PR89848Medicare PIN