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General NPI Number Information
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NPI Number | 1104217355
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Entity Type | Organization
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Legal Business Name | GSPROFESSIONALS, LLC
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Dates
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Enumeration Date | 02/10/2015
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Last Update Date | 02/10/2015
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Provider Practice Location Address
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Address Line | B5 CALLE TABONUCO SUITE 211
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City | GUAYNABO
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State | PR
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Zip | 00968-3004
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Country | US
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Telephone | 787-426-2554
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Fax |
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Provider Business Mailing Address
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Address Line | 1353 AVE LUIS VIGOREAUX PMB 314
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City | GUAYNABO
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State | PR
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Zip | 00966-2715
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Country | US
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Telephone | 787-426-2554
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | LILLAN C SANTOS
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Credential |
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Telephone | 787-426-2554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 18377
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License Number State | PR
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