Provider Demographics
NPI:1104523935
Name:GONZALEZ-OLIVERAS, VALERIA MARIE (MD)
Entity type:Individual
Prefix:
First Name:VALERIA
Middle Name:MARIE
Last Name:GONZALEZ-OLIVERAS
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 578
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-0578
Mailing Address - Country:US
Mailing Address - Phone:939-253-0697
Mailing Address - Fax:
Practice Address - Street 1:176 CALLE JOSE C VAZQUEZ
Practice Address - Street 2:BO. CAONILLAS
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-3309
Practice Address - Country:US
Practice Address - Phone:787-735-8001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23663208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice