Provider Demographics
NPI:1174744437
Name:GONZALEZ GARCIA, FLORENCIO (DC)
Entity type:Individual
Prefix:DR
First Name:FLORENCIO
Middle Name:
Last Name:GONZALEZ GARCIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 CALLE GEN DEL VALLE
Mailing Address - Street 2:
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00924-3722
Mailing Address - Country:US
Mailing Address - Phone:787-764-7663
Mailing Address - Fax:787-751-6887
Practice Address - Street 1:1017 CALLE GEN DEL VALLE
Practice Address - Street 2:
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00924-3722
Practice Address - Country:US
Practice Address - Phone:787-764-7663
Practice Address - Fax:787-751-6887
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR352111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5-0044Medicare ID - Type UnspecifiedPROVIDER ID