Healthcare Provider Details

I. General information

NPI: 1174162853
Provider Name (Legal Business Name): GAMALIER MESTRE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2019
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 AVE FONT MARTELO # 355
HUMACAO PR
00791-3249
US

IV. Provider business mailing address

11120 DORY CT
ORLANDO FL
32837-9163
US

V. Phone/Fax

Practice location:
  • Phone: 787-852-0768
  • Fax:
Mailing address:
  • Phone: 407-766-3260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number17327-I
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberHSE25971
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: