Provider Demographics
NPI:1518716513
Name:SOSA GONZALEZ, ANDRES BERNARDO
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:BERNARDO
Last Name:SOSA GONZALEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB VILLA MERCEDES 2900
Mailing Address - Street 2:CARR 834 #4046
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971
Mailing Address - Country:US
Mailing Address - Phone:787-840-2575
Mailing Address - Fax:
Practice Address - Street 1:URB VILLA MERCEDES 2900
Practice Address - Street 2:CARR 834 #4046
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00971
Practice Address - Country:US
Practice Address - Phone:787-840-2575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program