Healthcare Provider Details

I. General information

NPI: 1942516901
Provider Name (Legal Business Name): SONIA GILBES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2010
Last Update Date: 08/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BDA CLAUSELLS CALLE 6 NUM 89
PONCE PR
00731
US

IV. Provider business mailing address

BDA CLAUSELLS CALLE 6 NUM 89
PONCE PR
00731
US

V. Phone/Fax

Practice location:
  • Phone: 787-215-5657
  • Fax: 787-844-4130
Mailing address:
  • Phone: 787-215-5657
  • Fax: 787-844-4130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACI15620934
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: