Individual provider Active NPI

Wilma Enid Gonzalez, MS

  • Speech-Language Pathologist
  • Mayaguez, PR
National Provider Identifier
1568659043
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3001 Issued in PR
Practice address
410 Ave. Hostos Centro Pediatrico
Suite 1
Mayaguez, PR 00682
Phone
(787) 832-6015
Fax
(787) 832-6015
NPI assigned
Sep 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3001 PR Primary

Addresses

Primary practice location

410 Ave. Hostos Centro Pediatrico
Suite 1
Mayaguez, PR 00682

Mailing address

PO Box 706
Anasco, PR 00610-0706
Phone (787) 826-7632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3001PRMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190937600000",
    "number": "1568659043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 706",
            "city": "ANASCO",
            "state": "PR",
            "postal_code": "006100706",
            "telephone_number": "787-826-7632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 AVE. HOSTOS CENTRO PEDIATRICO",
            "address_2": "SUITE 1",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00682",
            "telephone_number": "787-832-6015",
            "fax_number": "787-832-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "WILMA",
        "middle_name": "ENID",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-28",
        "last_updated": "2007-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PR",
            "license": "3001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; 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.