Provider Demographics
NPI:1316133978
Name:GONZALEZ PONS, EDUARDO J (MD)
Entity type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:J
Last Name:GONZALEZ PONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:EDUARDO
Other - Middle Name:J
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:141 CALLE EUFRATES
Mailing Address - Street 2:URBANIZACION EL PARAISO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-450-8590
Mailing Address - Fax:
Practice Address - Street 1:CALLE HERNANDEZ CARRION
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:866-808-5771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR185752085R0202X, 2085R0204X
FLME1208792085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology