Healthcare Provider Details

I. General information

NPI: 1487933784
Provider Name (Legal Business Name): GISELA D PUIG CARRION M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2011
Last Update Date: 08/13/2020
Certification Date: 08/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO MEDICO HOSPITAL UNIVERSITARIO ADULTOS
SAN JUAN PR
00936
US

IV. Provider business mailing address

CONDOMINIO PINE GROVE APTARTAMENTO 46A
CAROLINA PR
00979-9050
US

V. Phone/Fax

Practice location:
  • Phone: 787-778-8505
  • Fax:
Mailing address:
  • Phone: 787-754-0101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number18771
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number18771
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number18771
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: