Healthcare Provider Details

I. General information

NPI: 1619864790
Provider Name (Legal Business Name): GPA SURGICAL PR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 NELSON PEREA, DOCTOR'S CENTER SUITE 206
MAYAGUEZ PR
00680-0037
US

IV. Provider business mailing address

1 CALLE INGA COND COSTAMAR 6D
SAN JUAN PR
00913
US

V. Phone/Fax

Practice location:
  • Phone: 917-808-6093
  • Fax:
Mailing address:
  • Phone: 917-808-6093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. GUILLERMO PUIG ARROYO
Title or Position: ORAL & MAXILLOFACIAL SURGEON
Credential: DMD
Phone: 917-808-6093