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General NPI Number Information
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NPI Number | 1285543579
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Entity Type | Individual
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Provider Name | JIZZYAN MARIE GESUALDO PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | AVE. TITO CASTRO 917 BUILDING A FLOOR 4
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City | PONCE
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State | PR
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Zip | 00732-7064
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Country | US
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Telephone | 787-601-1465
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Fax |
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Provider Business Mailing Address
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Address Line | HACIENDA LA MATILDE 5128 TRAPICHE
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City | PONCE
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State | PR
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Zip | 00728-2425
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Country | US
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Telephone | 787-601-1465
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 004692
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License Number State | PR
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