Provider Demographics
NPI:1770564239
Name:GONZALEZ, ZULMA A (MD)
Entity type:Individual
Prefix:MRS
First Name:ZULMA
Middle Name:A
Last Name: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:PO BOX 362403
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-2403
Mailing Address - Country:US
Mailing Address - Phone:787-765-7650
Mailing Address - Fax:787-766-4038
Practice Address - Street 1:AVE PONCE DE LEON
Practice Address - Street 2:HOPS AUXILIO MUTUO
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00919
Practice Address - Country:US
Practice Address - Phone:787-765-7650
Practice Address - Fax:787-766-4038
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4774208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
E15331Medicare UPIN
29126BMedicare ID - Type Unspecified