Healthcare Provider Details

I. General information

NPI: 1831072784
Provider Name (Legal Business Name): HEAD & NECK ONCOPLASTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 PASEO DEL VETERANO
PONCE PR
00716-2001
US

IV. Provider business mailing address

J8 AVE SAN PATRICIO APT 29
GUAYNABO PR
00968-4462
US

V. Phone/Fax

Practice location:
  • Phone: 787-812-3030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GABRIEL PUJOL CUEVAS
Title or Position: PRESIDENT
Credential: MD
Phone: 787-812-3030