Provider Demographics
NPI:1609812056
Name:GONZALEZ, LORNA
Entity Type:Individual
Prefix:DR
First Name:LORNA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 CALLE URUTI
Mailing Address - Street 2:URB. VILLA TOLEDO
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-9686
Mailing Address - Country:US
Mailing Address - Phone:787-452-0342
Mailing Address - Fax:787-880-2331
Practice Address - Street 1:415 CALLE URUTI
Practice Address - Street 2:URB. VILLA TOLEDO
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-9686
Practice Address - Country:US
Practice Address - Phone:787-452-0342
Practice Address - Fax:787-880-2331
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16419208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice