Provider Demographics
NPI:1902429368
Name:GONZALEZ, JOSE FELIPE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:FELIPE
Last Name:GONZALEZ
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 1:137 GUAYACAN ST.
Mailing Address - Street 2:CIUDAD JARDIN
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-9850
Mailing Address - Country:US
Mailing Address - Phone:787-309-0589
Mailing Address - Fax:
Practice Address - Street 1:URB NUESTRA SENORA DE LOURDES B 24
Practice Address - Street 2:CARR 848 KM 2 SAINT JUST
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-377-9299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR23516208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program