Healthcare Provider Details

I. General information

NPI: 1891963625
Provider Name (Legal Business Name): GEMEFA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2008
Last Update Date: 02/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166-O ANDRES RUIZ RIVERA
GURABO PR
00778
US

IV. Provider business mailing address

166-O ANDRES RUIZ RIVERA
GURABO PR
00778
US

V. Phone/Fax

Practice location:
  • Phone: 787-737-6441
  • Fax:
Mailing address:
  • Phone: 787-737-6441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: MAXIMINO MIRANDA
Title or Position: PRESEDENTE
Credential:
Phone: 787-737-6441