Healthcare Provider Details

I. General information

NPI: 1184219032
Provider Name (Legal Business Name): GDS HEALING HANDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2021
Last Update Date: 07/21/2022
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GALERA PACFICO SUITE 106 AVE LAS CUMBRES INT CARR 844
SAN JUAN PR
00926-0092
US

IV. Provider business mailing address

130 AVE WINSTON CHURCHILL PMB 187
SAN JUAN PR
00926-6065
US

V. Phone/Fax

Practice location:
  • Phone: 787-748-8585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GISELA M. DIAZ
Title or Position: PRESIDENT
Credential: DC
Phone: 787-748-8585