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General NPI Number Information
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NPI Number | 1720359268
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Entity Type | Individual
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Provider Name | NIEVES J GAZTAMBIDE M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 500 AVE JESUS T PINERO SUITE 1001
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City | SAN JUAN
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State | PR
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Zip | 00918-4003
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Country | US
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Telephone | 787-620-4042
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 364007
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City | SAN JUAN
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State | PR
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Zip | 00936-4007
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Country | US
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Telephone | 787-531-1125
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Fax | 787-946-9994
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 3934
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License Number State | PR
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