Provider Demographics
NPI:1619767043
Name:GONZALEZ, LORNA J (LND)
Entity type:Individual
Prefix:
First Name:LORNA
Middle Name:J
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB SAN FELIPE K1 CALLE 11
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-3365
Mailing Address - Country:US
Mailing Address - Phone:787-448-8958
Mailing Address - Fax:
Practice Address - Street 1:URB SAN FELIPE K1 CALLE 11
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-3365
Practice Address - Country:US
Practice Address - Phone:787-448-8958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1964133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist