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General NPI Number Information
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NPI Number | 1598416067
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Entity Type | Organization
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Legal Business Name | GASTRO CLASS LLC
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Dates
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Enumeration Date | 01/15/2022
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Last Update Date | 06/13/2023
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Provider Practice Location Address
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Address Line | 239 ARTERIAL HOSTOS AVE STE 305
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City | SAN JUAN
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State | PR
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Zip | 00918-1476
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Country | US
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Telephone | 939-236-3239
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Fax | 939-236-3239
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Provider Business Mailing Address
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Address Line | D14 CALLE PARKSIDE 6 APT 906
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City | GUAYNABO
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State | PR
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Zip | 00968-3338
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Country | US
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Telephone | 787-404-7820
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. WALISBETH CLASS
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Credential | MD
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Telephone | 787-404-7820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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