Provider Demographics
NPI:1801946900
Name:CENTRO AUDIOLOGICO E INTERDISCIPLINARIO, ISAMAR GONZALEZ, INC.
Entity type:Organization
Organization Name:CENTRO AUDIOLOGICO E INTERDISCIPLINARIO, ISAMAR GONZALEZ, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGYST
Authorized Official - Prefix:MS
Authorized Official - First Name:ISAMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-816-3195
Mailing Address - Street 1:HC 02 BOX 16367
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-9380
Mailing Address - Country:US
Mailing Address - Phone:787-816-3195
Mailing Address - Fax:
Practice Address - Street 1:HC 02 BOX 16367
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-9380
Practice Address - Country:US
Practice Address - Phone:787-816-3195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty