Provider Demographics
NPI:1932299112
Name:GONZALEZ, ROSARIO (PH)
Entity Type:Individual
Prefix:MRS
First Name:ROSARIO
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PH
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 221
Mailing Address - Street 2:
Mailing Address - City:BAJADERO
Mailing Address - State:PR
Mailing Address - Zip Code:00616-0221
Mailing Address - Country:US
Mailing Address - Phone:787-881-2035
Mailing Address - Fax:787-815-6886
Practice Address - Street 1:BO. SANTANA BZN. 1000
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-1000
Practice Address - Country:US
Practice Address - Phone:787-881-2035
Practice Address - Fax:787-815-6886
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F0491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist