Healthcare Provider Details

I. General information

NPI: 1841133709
Provider Name (Legal Business Name): GABRIEL HIRAM VALDES GUTIERREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 SAVANNAH REAL
SAN LORENZO PR
00754-4133
US

IV. Provider business mailing address

408 SAVANNAH REAL
SAN LORENZO PR
00754-4133
US

V. Phone/Fax

Practice location:
  • Phone: 787-914-7831
  • Fax:
Mailing address:
  • Phone: 787-914-7831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1167
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: