Provider Demographics
NPI:1316083108
Name:GONZALEZ CORCHADO, GAIL VANESA (MD)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:VANESA
Last Name:GONZALEZ CORCHADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:HC 6 BOX 64602
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-9841
Mailing Address - Country:US
Mailing Address - Phone:787-609-7823
Mailing Address - Fax:
Practice Address - Street 1:AVE AGUSTIN RAMOS CALERO CARR 112
Practice Address - Street 2:KM 1.4 INT
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-830-2705
Practice Address - Fax:787-830-3059
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR16696208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice