Provider Demographics
NPI:1861042723
Name:GONZALEZ GONZALEZ, ONIEL
Entity Type:Individual
Prefix:DR
First Name:ONIEL
Middle Name:
Last Name:GONZALEZ GONZALEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 CALLE PEDRO PEREZ
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-4516
Mailing Address - Country:US
Mailing Address - Phone:787-242-0833
Mailing Address - Fax:
Practice Address - Street 1:CARR 2 KM 124 BO. CAIMITAL ALTO
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:939-292-3119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR697111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor