Provider Demographics
NPI:1215656905
Name:GONZALEZ, VERONICA LEE
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:LEE
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 1:500 AVE MUNOZ RIVERA STE 249
Mailing Address - Street 2:CONDOMINIO EL CENTRO I
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3346
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 AVE MUNOZ RIVERA STE 249
Practice Address - Street 2:CONDOMINIO EL CENTRO I
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3346
Practice Address - Country:US
Practice Address - Phone:787-503-9192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist