Provider Demographics
NPI:1871251165
Name:GONZALEZ AGRONT, CINDY KRISTINA (DRA)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:KRISTINA
Last Name:GONZALEZ AGRONT
Suffix:
Gender:F
Credentials:DRA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1106
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-1106
Mailing Address - Country:US
Mailing Address - Phone:787-566-4173
Mailing Address - Fax:
Practice Address - Street 1:CARR 125 KM 5.5
Practice Address - Street 2:BO VOLADORAS
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-0067
Practice Address - Country:US
Practice Address - Phone:787-566-4173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-03
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7162103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty