Geraldo Gonzalez, M.D.
Individual provider Active NPI General Practice Physician · Lares, PR
NPI 1164590816 · NPPES record last updated Oct 16, 2015
Key facts
- NPI
- 1164590816
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 13643 (PR)
- Practice address
- Carr 129 KM 21.2
Lares, PR 00669-0916 - Phone
- (787) 897-0560
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050621000124 | PR | Practitioner - General Practice | 1052355724 |
Reassigns benefits to 1 organization Practice locations: Lares, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Laboratorio Clinico Bacteriologico Lares Inc | Current | Accepting new patients | |
| San Lazargerd Medical II CSP | General Practice | Current |
Accepting new patients |
| San Gerardo Medical Center CSP | Past |
Accepting new patients | |
| San Lazargerd Medical Center, CSP | Past |
Accepting new patients | |
| San Lazargerd Medical II CSP | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 13643 | PR | Yes |
Addresses
Primary practice location
Carr 129 KM 21.2
Lares, PR 00669-0916
Mailing address
PO Box 916
Lares, PR 00669-0916
Phone (787) 897-0560
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100105W | Other | MMM | |
| 20634 | Other | TS | |
| 1105A | Other | PMC | |
| 6606242211 | Other | MCS |
Other providers in Lares, PR
- Rigoberto Gonzalez Perez
- Carmira Jazmin Gonzalez Rodriguez
- Adalberto Rafael Gonzalez-Carbia Sr.
- Joanelly Gonzalez-Irizarry
- Cindy Gonzalez
- Jose J Gonzalez
- Magaly Gonzalez
- Stephanie Yasmin Gonzalez
- Luis Alberto Grana Santiago
- Grupo Sala Emergencia Lares Medical Center
All providers in Lares, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.