Provider Demographics
NPI:1679666739
Name:GONZALEZ GONZALEZ, GERMAN LUIS (MD)
Entity Type:Individual
Prefix:
First Name:GERMAN
Middle Name:LUIS
Last Name:GONZALEZ GONZALEZ
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 923
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660-0923
Mailing Address - Country:US
Mailing Address - Phone:787-264-2124
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA # 2 KM 174.0
Practice Address - Street 2:SAN GERMAN MEDICAL PLAZA SUITE 202
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-1905
Practice Address - Country:US
Practice Address - Phone:787-264-2124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR166602083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine