Provider Demographics
NPI:1124248034
Name:GONZALEZ CINTRON, JOSETTE
Entity type:Individual
Prefix:
First Name:JOSETTE
Middle Name:
Last Name:GONZALEZ CINTRON
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:PALACIOS DEL RIO II
Mailing Address - Street 2:CALLE GUAJATACA 731
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-781-8179
Mailing Address - Fax:
Practice Address - Street 1:GARDEN HILLS PLAZA 1379
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:787-781-8179
Practice Address - Fax:787-749-9435
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
183700000X
PR5466183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5466OtherPHARMACIST THECNICIAN