Basic Information
| Provider Information | |||||||||
| NPI: | 1386899839 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GONZALEZ PAGAN | ||||||||
| FirstName: | JAHZEL | ||||||||
| MiddleName: | MICHELLE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 186 CARRETERA 2 ACQUALINA CONDOMINIUM | ||||||||
| Address2: | APT 503 | ||||||||
| City: | GUAYNABO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00966 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7873815452 | ||||||||
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| Practice Location | |||||||||
| Address1: | UPR MEDICAL SCIENCE CAMPUS | ||||||||
| Address2: | SUITE 209 | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009365067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877564020 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/25/2008 | ||||||||
| LastUpdateDate: | 01/05/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0204X | 18125 | PR | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Emergency Medicine |
No ID Information.