Provider Demographics
NPI:1285702589
Name:GONZALEZ PUJOLS, ANGEL RAFAEL
Entity type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:RAFAEL
Last Name:GONZALEZ PUJOLS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 304
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792
Mailing Address - Country:US
Mailing Address - Phone:787-852-7514
Mailing Address - Fax:787-852-1514
Practice Address - Street 1:C FONT MARTELO
Practice Address - Street 2:#104
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-852-7514
Practice Address - Fax:787-852-1514
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4430208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics