Provider Demographics
NPI:1861432908
Name:PUJOLS GONZALEZ, CARMEN G (MD)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:G
Last Name:PUJOLS GONZALEZ
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:PO BOX 1607
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-1607
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1153 AVE EMERITO ESTRADA RIVERA
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-3016
Practice Address - Country:US
Practice Address - Phone:787-896-4700
Practice Address - Fax:787-926-0365
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR009034208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1795-1OtherPROSSAM
PR9034OtherCOSVI
PR3398OtherINTERNATIONAL CARD SYSTEM
PR660548615OtherMCS
PR80742OtherSSS
PR067357OtherCRUZ AZUL
PR7550-001OtherHUMANA
PR9034OtherCIGNA
PR3398OtherINTERNATIONAL CARD SYSTEM