Provider Demographics
NPI:1144367103
Name:GONZALEZ DEL RIO, EVELYN (MD)
Entity type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:
Last Name:GONZALEZ DEL RIO
Suffix:
Gender:F
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:RR04 BUZON 5056
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610
Mailing Address - Country:US
Mailing Address - Phone:787-818-2065
Mailing Address - Fax:787-818-2065
Practice Address - Street 1:207 CALLE JUAN SAN ANTONIOEDF BOSQUES #9
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-818-2065
Practice Address - Fax:787-818-2065
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11702208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics