Healthcare Provider Details

I. General information

NPI: 1083301238
Provider Name (Legal Business Name): GERIOPUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 CALLE 42 SE
SAN JUAN PR
00921-2720
US

IV. Provider business mailing address

1010 CALLE 42 SE
SAN JUAN PR
00921-2720
US

V. Phone/Fax

Practice location:
  • Phone: 787-595-8337
  • Fax:
Mailing address:
  • Phone: 787-595-8337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID HERNANDEZ RIVERA
Title or Position: CEO
Credential: MD
Phone: 787-595-8337