Provider Demographics
NPI:1457324535
Name:GONZALEZ-BADILLO, ORLANDO (MD)
Entity type:Individual
Prefix:DR
First Name:ORLANDO
Middle Name:
Last Name:GONZALEZ-BADILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 568
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-0568
Mailing Address - Country:US
Mailing Address - Phone:787-877-3940
Mailing Address - Fax:
Practice Address - Street 1:112 CALLE DON CHEMARY
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-4125
Practice Address - Country:US
Practice Address - Phone:787-877-6500
Practice Address - Fax:787-877-6350
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11701208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice