Provider Demographics
NPI:1114457009
Name:GONZALEZ JIMENEZ, RIGOBERTO (MD)
Entity type:Individual
Prefix:
First Name:RIGOBERTO
Middle Name:
Last Name:GONZALEZ JIMENEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 PLAZA CARMEN
Mailing Address - Street 2:
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-9128
Mailing Address - Country:US
Mailing Address - Phone:939-325-2945
Mailing Address - Fax:
Practice Address - Street 1:STREET 695 KM 2.0, URB. DORAVILLE OFFICE 2
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:939-325-2945
Practice Address - Fax:939-333-2169
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19655208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice