Provider Demographics
NPI:1598803538
Name:GONZALEZ - TAULL, ROSALINDA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSALINDA
Middle Name:
Last Name:GONZALEZ - TAULL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8ST.VILLA NEVAREZ
Mailing Address - Street 2:1025
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-5214
Mailing Address - Country:US
Mailing Address - Phone:787-384-9386
Mailing Address - Fax:
Practice Address - Street 1:RADIOLOGIA RCM
Practice Address - Street 2:BOX 29134
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00929-0134
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR87002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE-95199Medicare UPIN
PR0022583Medicare ID - Type Unspecified