Grace Marie Gonzalez, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

000539-PA Issued in PR

Practice address

Rodriguez Olmo, Calle Armando Vega Colon
Numero 25
Arecibo, PR 00612

Phone

(939) 491-0265

NPI assigned

Nov 6, 2020

Last updated

Nov 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1174124929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RODRIGUEZ OLMO CALLE ARMANDO VEGA COLON",
            "address_2": "NO. 25",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "939-491-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RODRIGUEZ OLMO, CALLE ARMANDO VEGA COLON",
            "address_2": "NUMERO 25",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "939-491-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "GRACE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PR",
            "license": "000539-PA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE",
            "identifier": "000539-PA",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carmen Geraldine Gonzalez, PSY. D.
• Dorabelle Gonzalez, M.D.
• Eddie N Gonzalez Sr., PH
• Eladio Jose Gonzalez, MD
• Eunice Gonzalez
• Ineabelle Gonzalez, PA
• Irma L Gonzalez, DMD
• Isamar Gonzalez, LCDA.
• Jenniffer Gonzalez, MS PHL
• Jesseka Darlene Gonzalez

• Medical Physician Assistant in Arecibo, PR
• Providers in Arecibo, PR by specialty
• Medical Physician Assistant in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.