Provider Demographics
NPI:1639251119
Name:GOMEZ RODRIGUEZ, ANGEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:M
Last Name:GOMEZ RODRIGUEZ
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:A31 CALLE NAVARRA
Mailing Address - Street 2:VILLAS DEL SAGRADO CORAZON
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:787-689-0443
Mailing Address - Fax:
Practice Address - Street 1:CARR 14 KM 32.5
Practice Address - Street 2:CALLE JOSE I QUINTON
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769
Practice Address - Country:US
Practice Address - Phone:787-689-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR144252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry