Provider Demographics
NPI:1740681667
Name:CARIDAD GONZALEZ GARCIA MD CSP
Entity type:Organization
Organization Name:CARIDAD GONZALEZ GARCIA MD CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTA
Authorized Official - Prefix:DR
Authorized Official - First Name:CARIDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-650-2888
Mailing Address - Street 1:46 CALLE ROBLES
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-9585
Mailing Address - Country:US
Mailing Address - Phone:787-650-2888
Mailing Address - Fax:787-650-2888
Practice Address - Street 1:46 CALLE ROBLES
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-9585
Practice Address - Country:US
Practice Address - Phone:787-650-2888
Practice Address - Fax:787-650-2888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18379208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRFW338AOtherPTAN