Provider Demographics
NPI:1942045422
Name:GONZALEZ ROMAN, MONICA
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:GONZALEZ ROMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PARC PEREZ
Mailing Address - Street 2:A1 CALLE A
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-5490
Mailing Address - Country:US
Mailing Address - Phone:939-250-2901
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1142
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-1142
Practice Address - Country:US
Practice Address - Phone:787-621-3700
Practice Address - Fax:787-621-3266
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16968208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice