Provider Demographics
NPI:1811297534
Name:ABRAHAM GONZALEZ, MANUEL EDUARDO (MD)
Entity type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:EDUARDO
Last Name:ABRAHAM GONZALEZ
Suffix:
Gender:
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:CORAL BEACH APT. 1720 TOWER 1 ISLA VERDE AVE.
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979
Mailing Address - Country:US
Mailing Address - Phone:787-383-1530
Mailing Address - Fax:
Practice Address - Street 1:CALLE LOIZA #1854, ALTOS FARMACIA AMERICANA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911
Practice Address - Country:US
Practice Address - Phone:787-383-1530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1516208D00000X
PR18081208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice