Provider Demographics
NPI:1710231444
Name:GONZALEZ-VIRUET, MARIBELLA (PHD)
Entity type:Individual
Prefix:DR
First Name:MARIBELLA
Middle Name:
Last Name:GONZALEZ-VIRUET
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3011 ALEJADRINO AVE
Mailing Address - Street 2:COND. VIEW POINT APT 504
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-638-3520
Mailing Address - Fax:
Practice Address - Street 1:1788 CALLE JULIO AYBAR
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-4410
Practice Address - Country:US
Practice Address - Phone:787-638-3520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-02
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2114103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical