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General NPI Number Information
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NPI Number | 1144696329
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Entity Type | Individual
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Provider Name | LUIS MANUEL GESUALDO ALBORS M.D
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Gender | Male
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Dates
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Enumeration Date | 08/11/2015
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Last Update Date | 08/09/2016
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Provider Practice Location Address
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Address Line | HACIENDAS DEL MONTE,PASEO LA FORTUNA 7009
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City | COTO LAUREL
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State | PONCE
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Zip | 00780
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Country | UM
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Telephone | 787-340-8122
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Fax | 787-812-0404
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Provider Business Mailing Address
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Address Line | HACIENDAS DEL MONTE,PASEO LA FORTUNA 7009
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City | COTO LAUREL
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State | PONCE
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Zip | 00780
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Country | UM
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Telephone | 787-340-8122
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Fax | 787-812-0404
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 19291
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License Number State | PR
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