Provider Demographics
NPI:1881395994
Name:GONZALEZ, LUZ ARISTUD
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:ARISTUD
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE RAMON QUINONES F21
Mailing Address - Street 2:URB EDUARDO SALDANA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00963
Mailing Address - Country:US
Mailing Address - Phone:787-516-9135
Mailing Address - Fax:
Practice Address - Street 1:PABELLON B CALLE MAGA CENTRO MCDICO BARRIO MONACILLOS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935-0001
Practice Address - Country:US
Practice Address - Phone:787-764-0684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR031389163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)