Provider Demographics
NPI:1821153305
Name:GONZALEZ MUNOZ, CARMEN EDEYL (MD)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:EDEYL
Last Name:GONZALEZ MUNOZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 461
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-0461
Mailing Address - Country:US
Mailing Address - Phone:787-819-0347
Mailing Address - Fax:787-819-0347
Practice Address - Street 1:CALLE A #72
Practice Address - Street 2:URB. CRISTAL
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-819-0347
Practice Address - Fax:787-819-0347
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9203207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR8-4292Medicare ID - Type UnspecifiedDOCTOR