Provider Demographics
NPI:1679850929
Name:GONZALEZ, JOSE ABNER (RPH)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:ABNER
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE ALMACIGO H27
Mailing Address - Street 2:URB. ARBOLADA
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-0000
Mailing Address - Country:US
Mailing Address - Phone:939-940-4900
Mailing Address - Fax:
Practice Address - Street 1:CALLE ALMACIGO H27
Practice Address - Street 2:URB. ARBOLADA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-742-0001
Practice Address - Fax:787-742-0176
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist