Active NPI
Eunice Gonzalez Guang, LCDA.
- Registered Dietitian
- San Juan, PR
National Provider Identifier
1629736780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 001291
- Practice address
- 1492 Ponce de Leon Ave
Edificio Centro Europa 717
San Juan, PR 00907 - Phone
- (787) 723-5017
- Fax
- (787) 723-5015
- NPI assigned
- Dec 6, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 001291 | PR | Primary |
Addresses
Primary practice location
1492 Ponce de Leon Ave
Edificio Centro Europa 717
San Juan, PR 00907
Mailing address
PO Box 11577
Fernandez Juncos Station
San Juan, PR 00910
Phone (787) 723-5017
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001291 | Other | PR | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220201002515 | PR | Practitioner - Registered Dietitian Or Nutrition Professional | 8729471446 | Practice locations: San Juan, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001291 | PR | MD | Registered Dietitian |
| 1291 | PR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiomed LLC | Current | Accepting new patients | |
| Cardiovascular Healthcare LLC | Current | Accepting new patients |
Locations
1492 Ave Ponce de Leon
Ste 717
Santurce, PR 00907
Phone (787) 462-0646
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- San Juan, PR
- NPI 1104206028
-
- Cardiovascular Disease Physician
- San Juan, PR
- NPI 1992225536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638748800000",
"number": "1629736780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11577",
"address_2": "FERNANDEZ JUNCOS STATION",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00910",
"telephone_number": "787-723-5017",
"fax_number": "787-723-5015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1492 PONCE DE LEON AVE",
"address_2": "EDIFICIO CENTRO EUROPA 717",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00907",
"telephone_number": "787-723-5017",
"fax_number": "787-723-5015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ GUANG",
"first_name": "EUNICE",
"credential": "LCDA.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-06",
"last_updated": "2021-12-06",
"certification_date": "2021-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PR",
"license": "001291",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "001291",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Juan, PR
- Sofia Isabel Gonzalez Espola
- Carlos Ruben Gonzalez Fuentes, M.D.
- Carlos J. Gonzalez Garcia, M.D.
- Stephanie Michelle Gonzalez Garcia, MD
- Naiomi Gonzalez Gorritz, PHARM D
- Leidiana Gonzalez Guerrero
- Luis D Gonzalez Hernandez, MD
- Lilibeth Gonzalez Lebron
- Gonzalo V Gonzalez Liboy, MD FACP
- Fe M Gonzalez Lopez
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.