Provider Demographics
NPI:1740092253
Name:GONZALEZ, JOHNNY RAMIRO
Entity type:Individual
Prefix:
First Name:JOHNNY
Middle Name:RAMIRO
Last Name: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 1:12606 GOODHILL RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-4138
Mailing Address - Country:US
Mailing Address - Phone:240-370-9480
Mailing Address - Fax:
Practice Address - Street 1:12606 GOODHILL RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-4138
Practice Address - Country:US
Practice Address - Phone:240-370-9480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter