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General NPI Number Information
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NPI Number | 1669538716
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Entity Type | Organization
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Legal Business Name | GASTROINTESTINAL DISEASES AND NUTRITION CONSULTANT
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Dates
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Enumeration Date | 12/30/2006
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Last Update Date | 05/23/2012
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Provider Practice Location Address
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Address Line | 735 AVE PONCE DE LEON TORRE MEDICA AUXILIO MUTUO SUITE 402
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City | HATO REY
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State | PR
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Zip | 00917-5022
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Country | US
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Telephone | 787-777-0977
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Fax | 787-777-0981
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Provider Business Mailing Address
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Address Line | PO BOX 19865
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City | SAN JUAN
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State | PR
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Zip | 00910-1865
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Country | US
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Telephone | 787-777-0977
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Fax | 787-777-0981
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Authorized Official
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Title or Position | PRESIDENT
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Name | KERMIT J RIHCIEZ
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Credential | M.D.
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Telephone | 787-777-0977
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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 | 10441
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License Number State | PR
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