Provider Demographics
NPI:1750997904
Name:ESPARRA GONZALEZ, MARALYS NANETTE (MD)
Entity type:Individual
Prefix:DR
First Name:MARALYS
Middle Name:NANETTE
Last Name:ESPARRA GONZALEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 15379
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-9617
Mailing Address - Country:US
Mailing Address - Phone:787-452-1520
Mailing Address - Fax:
Practice Address - Street 1:153 AVE JOSE DE DIEGO E
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-3847
Practice Address - Country:US
Practice Address - Phone:787-738-4539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22023202C00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner