Provider Demographics
NPI:1588959357
Name:GONZALEZ, JENNIFER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A27 CALLE 4
Mailing Address - Street 2:ESTANCIAS DE SAN FERNANDO
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-5208
Mailing Address - Country:US
Mailing Address - Phone:787-810-9210
Mailing Address - Fax:
Practice Address - Street 1:A27 CALLE 4
Practice Address - Street 2:ESTANCIAS DE SAN FERNANDO
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-5208
Practice Address - Country:US
Practice Address - Phone:787-810-9210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5465183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist