Dra Madeline Fernandez Gonzalez CSP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11858 Issued in PR

Legal business name

DRA MADELINE FERNANDEZ GONZALEZ CSP

Practice address

2431 Blvd Luis a Ferre
Edificio Porrata Pila Ste 311
Ponce, PR 00717-2113

Phone

(787) 843-0003

Fax

(787) 843-0003

NPI assigned

Sep 14, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Madeline Fernandez Gonzalez, MDNPI 1043316607

Title

President

Phone

(787) 843-0003

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Tax ID family

Dra Madeline Fernandez Gonzalez CSP2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Madeline Fernandez Gonzalez CSP

  • Family Medicine Physician
  • Ponce, PR
  • NPI 1033533179
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Madeline Fernandez Gonzalez, M.D

  • Family Medicine Physician
  • Ponce, PR
  • NPI 1043316607
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482969600000",
    "number": "1720184385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 BLVD LUIS A FERRE",
            "address_2": "EDIFICIO PORRATA PILA STE 311",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007172113",
            "telephone_number": "787-843-0003",
            "fax_number": "787-841-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 BLVD LUIS A FERRE",
            "address_2": "EDIFICIO PORRATA PILA STE 311",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007172113",
            "telephone_number": "787-843-0003",
            "fax_number": "787-843-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRA MADELINE FERNANDEZ GONZALEZ CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2016-12-29",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ GONZALEZ",
        "authorized_official_first_name": "MADELINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-843-0003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "11858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Ponce, PR
• Providers in Ponce, PR by specialty
• Family Medicine Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.

Verify at the official NPI Registry.