Healthcare Provider Details

I. General information

NPI: 1326197401
Provider Name (Legal Business Name): GILBERTO J ALVARADO DIAZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2360 AVE EDUARDO RUBERTE
PONCE PR
00717-0304
US

IV. Provider business mailing address

PO BOX 8726
PONCE PR
00732-8726
US

V. Phone/Fax

Practice location:
  • Phone: 787-844-8000
  • Fax:
Mailing address:
  • Phone: 787-841-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number16456
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: