Provider Demographics
NPI:1740483296
Name:GONZALEZ, JENNIFFER MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFFER
Middle Name:MARIE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:48 AVE MUNOZ RIVERA APT 1607
Mailing Address - Street 2:COND AQUABLUE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-648-8548
Mailing Address - Fax:
Practice Address - Street 1:COND. AQUABLUE
Practice Address - Street 2:48 AVE. MUNOZ RIVERA APT. 1607
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-648-8548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17563207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine