Provider Demographics
NPI:1487751707
Name:GONZALEZ - TEJERA, GLORIA M (MD)
Entity type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:M
Last Name:GONZALEZ - TEJERA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:AVE. ROOSEVELT 400
Mailing Address - Street 2:OFICINA 410 CLINICA LAS AMERICAS
Mailing Address - City:HATO REY
Mailing Address - State:PR
Mailing Address - Zip Code:00919
Mailing Address - Country:US
Mailing Address - Phone:787-753-6414
Mailing Address - Fax:787-763-7125
Practice Address - Street 1:AVE. ROOSEVELT 400
Practice Address - Street 2:OFICINA 410 CLINICA LAS AMERICAS
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00919
Practice Address - Country:US
Practice Address - Phone:787-753-6414
Practice Address - Fax:787-763-7125
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2013-07-17
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Provider Licenses
StateLicense IDTaxonomies
PR69242084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry