Healthcare Provider Details

I. General information

NPI: 1558049031
Provider Name (Legal Business Name): GYNECO MD, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 07/06/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BAYAMON MEDICAL PLAZA 1845 CARR 2 STE 508
BAYAMON PR
00959-7204
US

IV. Provider business mailing address

PO BOX 8367
BAYAMON PR
00960-8367
US

V. Phone/Fax

Practice location:
  • Phone: 787-798-5323
  • Fax:
Mailing address:
  • Phone: 787-242-1628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LAURA PATRICIA SEDA RODRIGUEZ
Title or Position: OBSTETRICS AND GYNECOLOGY
Credential: MD
Phone: 787-242-1628