Healthcare Provider Details

I. General information

NPI: 1033471768
Provider Name (Legal Business Name): GABRIELA R DE BOER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GABRIELA RODRIGUEZ COLON MD

II. Dates (important events)

Enumeration Date: 06/08/2012
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1995 METRO MEDICAL CENTER SUITE 401-410
BAYAMON PR
00959-5065
US

IV. Provider business mailing address

1 AVE FOMENTO STE 1
CAGUAS PR
00725-5700
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-3030
  • Fax: 787-641-3031
Mailing address:
  • Phone: 787-641-3030
  • Fax: 787-641-3031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number23423
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number2016-00916
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: