Provider Demographics
NPI:1891359329
Name:DRA DAMARYS GONZALEZ GALICIA PSC
Entity Type:Organization
Organization Name:DRA DAMARYS GONZALEZ GALICIA PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMARYS
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-477-0342
Mailing Address - Street 1:PO BOX 1586
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-1586
Mailing Address - Country:US
Mailing Address - Phone:787-477-0342
Mailing Address - Fax:787-658-6102
Practice Address - Street 1:CARR 417 KM 4.2
Practice Address - Street 2:BO MAMEY
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-0060
Practice Address - Country:US
Practice Address - Phone:787-477-0342
Practice Address - Fax:787-658-6102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service