Provider Demographics
NPI:1891777330
Name:GONZALEZ-HERNANDEZ, MAGALI E (MPT, PT)
Entity Type:Individual
Prefix:MS
First Name:MAGALI
Middle Name:E
Last Name:GONZALEZ-HERNANDEZ
Suffix:
Gender:F
Credentials:MPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 894
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-0894
Mailing Address - Country:US
Mailing Address - Phone:787-733-8184
Mailing Address - Fax:787-733-8184
Practice Address - Street 1:44 CALLE BARBOSA
Practice Address - Street 2:
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771-3939
Practice Address - Country:US
Practice Address - Phone:787-733-8184
Practice Address - Fax:787-733-8184
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR575225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1604OtherIMC - FIRST MEDICAL
PR89259OtherFIRST PLUS
PR3302709OtherACAA
PR6400037OtherHUMANA HEALTH PLANS OF PR
PR34625OtherPROSAM
PR660506980OtherVETERANO - FEE BASIS
PR890098OtherMMM
PR6400037OtherHUMANA HEALTH PLANS OF PR