Provider Demographics
NPI:1588623185
Name:GONZALEZ CASIANO, NORMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:
Last Name:GONZALEZ CASIANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 713
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-0713
Mailing Address - Country:US
Mailing Address - Phone:787-821-6053
Mailing Address - Fax:
Practice Address - Street 1:BO.MAGUEYES
Practice Address - Street 2:SOLAE #3
Practice Address - City:GUANICA
Practice Address - State:PR
Practice Address - Zip Code:00653
Practice Address - Country:US
Practice Address - Phone:787-821-6053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14521207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH81574Medicare UPIN
PR0084736Medicare ID - Type Unspecified