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General NPI Number Information
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NPI Number | 1174628697
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Entity Type | Organization
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Legal Business Name | GASTRO METABOLIC SERVICES PSC
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 735 AVE PONCE DE LEON STE 605 CONDOMINIO TORRE DE AUXILIO MUTUO
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City | SAN JUAN
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State | PR
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Zip | 00917-5028
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Country | US
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Telephone | 787-282-6301
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Fax | 787-759-7422
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Provider Business Mailing Address
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Address Line | 735 AVE PONCE DE LEON SUITE 605 CONDOMINIO TORRE DE AUXILIO MUTUO
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City | SAN JUAN
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State | PR
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Zip | 00917-5022
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Country | US
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Telephone | 787-282-6301
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Fax | 787-759-7422
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DR. MANUEL E IMBERT GARRATON
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Credential | MD
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Telephone | 787-282-6301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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