Ernesto Gonzalez Cebollero, MD
Individual provider Active NPI General Practice Physician · Rincon, PR
NPI 1528059367 · NPPES record last updated Jun 30, 2010
Key facts
- NPI
- 1528059367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 1131D (PR)
- Practice address
- LM Rivera 55 Oeste
Rincon, PR 00677 - Phone
- (787) 823-6831
- NPI assigned
- Nov 1, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| I20031120000017 | PR | Practitioner - General Practice | 2062316300 | Practice locations: Rincon, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1131D | PR | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 1131D | PR | Yes |
Addresses
Primary practice location
LM Rivera 55 Oeste
Rincon, PR 00677
Mailing address
PO Box 386
Anasco, PR 00610-0386
Phone (787) 823-6831
Other providers in Rincon, PR
- Daniel Flores
- Margarita Font Bonet
- GNS Agront Inc
- Carlos E Gomez
- Jesus Valentin Gomez
- Sandra Marie Gonzalez Narvaez
- Coralys Del Mar Gonzalez Torres
- Abnier Gonzalez
- Coralis Naomi Gonzalez
- Gerardo A Gonzalez
All providers in Rincon, 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 Jun 30, 2010. 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.