Provider Demographics
NPI:1720017098
Name:GONZALEZ ALMEIDA, MARCOS ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:ANTONIO
Last Name:GONZALEZ ALMEIDA
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:HACIENDA BORINQUEN CALLE ALMENDRO CASA 111
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-258-5065
Mailing Address - Fax:
Practice Address - Street 1:CARR PR 5 KM 2.8
Practice Address - Street 2:EDIF JOB ANDUJAR
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962-0001
Practice Address - Country:US
Practice Address - Phone:787-385-7997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16037208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR23455Medicare ID - Type Unspecified