Healthcare Provider Details

I. General information

NPI: 1093671190
Provider Name (Legal Business Name): GUSTAVO INSIGNARES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 8
CAROLINA PR
00986-0008
US

IV. Provider business mailing address

3028 SW 153RD PATH
MIAMI FL
33185-4884
US

V. Phone/Fax

Practice location:
  • Phone: 787-626-3322
  • Fax:
Mailing address:
  • Phone: 786-499-2268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number17418I
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: