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General NPI Number Information
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NPI Number | 1255932752
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Entity Type | Organization
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Legal Business Name | DR GUSTAVO CEDENO QUINTERO PSC
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 11/03/2020
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Provider Practice Location Address
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Address Line | 58 CALLE EDUARDO GEORGETTI
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City | VEGA ALTA
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State | PR
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Zip | 00692-7096
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Country | US
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Telephone | 787-484-5103
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3022
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City | VEGA ALTA
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State | PR
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Zip | 00692-3022
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Country | US
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Telephone | 787-484-5103
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GUSTAVO CEDENO QUINTERO
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Credential | MD
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Telephone | 787-484-5103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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