Johannie Gonzalez, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

019369 Issued in PR

Practice address

Bo Bayaney Carr 129 KM 13.6
Hatillo, PR 00659-0000

Phone

(787) 317-7129

NPI assigned

Oct 24, 2016

Last updated

Jan 4, 2021By 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

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1629529763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 3 BOX 20416",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006128126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BO BAYANEY CARR 129 KM 13.6",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006590000",
            "telephone_number": "787-317-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JOHANNIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-24",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "019369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adiannette Gonzalez, O.D.
• Adrian Javier Gonzalez
• Carmen P Gonzalez
• Cristina B Gonzalez, OPT
• Jacqueline Gonzalez, PHARMACY TECHNICIAN
• Maria del Mar Gonzalez, LIC. , COL.
• Raphy Alexis Gonzalez, MD
• Rut Violeta Gonzalez
• Alberto G Grana, M.D.
• Green Hills Pharmacy Corp. (Green Hills Pharmacy)

• General Practice Physician in Hatillo, PR
• Providers in Hatillo, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.