Healthcare Provider Details

I. General information

NPI: 1861427650
Provider Name (Legal Business Name): LUIS M GELY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 10/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 AVE MUNOZ MARIN SUITE 303
CAGUAS PR
00725-3975
US

IV. Provider business mailing address

50 AVENUE MUNOZ MARIN SUITE 303
CAGUAS PR
00725-3982
US

V. Phone/Fax

Practice location:
  • Phone: 787-745-2666
  • Fax: 787-745-2662
Mailing address:
  • Phone: 787-745-2666
  • Fax: 787-745-2662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number010524
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: