Provider Demographics
NPI:1023259033
Name:GONZALEZ, DAISY QUILES (MACPL)
Entity type:Individual
Prefix:MRS
First Name:DAISY
Middle Name:QUILES
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MACPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COM. MORA GUERRERO BZN.3 CALLE1
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662
Mailing Address - Country:US
Mailing Address - Phone:787-872-7314
Mailing Address - Fax:787-872-7314
Practice Address - Street 1:COM. MORA GUERRERO BZN.3 CALLE1
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-872-7314
Practice Address - Fax:787-872-7314
Is Sole Proprietor?:No
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2111101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health