Provider Demographics
NPI:1588690424
Name:GONZALEZ, ROBERTO H SR (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:H
Last Name:GONZALEZ
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:127B CALLE COLON
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-3166
Mailing Address - Country:US
Mailing Address - Phone:787-868-7110
Mailing Address - Fax:787-868-7110
Practice Address - Street 1:127B CALLE COLON
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-3166
Practice Address - Country:US
Practice Address - Phone:787-868-7110
Practice Address - Fax:787-868-7110
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9353174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist