Provider Demographics
NPI:1629617113
Name:GONZALEZ ROSARIO, KARINA JOAN
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:JOAN
Last Name:GONZALEZ ROSARIO
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:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-1330
Mailing Address - Country:US
Mailing Address - Phone:787-739-8182
Mailing Address - Fax:787-714-1444
Practice Address - Street 1:PARQUE INDUSTRIAL SUR. CARR 9939
Practice Address - Street 2:
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771
Practice Address - Country:US
Practice Address - Phone:787-739-8182
Practice Address - Fax:787-912-0307
Is Sole Proprietor?:No
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR006488183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist