Provider Demographics
NPI:1972498715
Name:MESIAS GONZALEZ, ANDRES MIGUEL
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:MIGUEL
Last Name:MESIAS 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 1:204 CAROL ANN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01128-1306
Mailing Address - Country:US
Mailing Address - Phone:203-737-0991
Mailing Address - Fax:
Practice Address - Street 1:73 LOUDERS LN
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-3424
Practice Address - Country:US
Practice Address - Phone:203-737-0991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter