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General NPI Number Information
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NPI Number | 1740943638
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Entity Type | Individual
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Provider Name | GABRIELA MALDONADO TORRES OD
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Gender | Female
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Dates
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Enumeration Date | 10/18/2021
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | CLINICA VISUAL VILLALBA #31 CALLE LUIS MUNOZ RIVERA
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City | VILLALBA
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State | PR
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Zip | 00766
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Country | US
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Telephone | 787-847-1234
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Fax |
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Provider Business Mailing Address
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Address Line | CLINICA VISUAL VILLALBA #31 CALLE LUIS MUOZ RIVERA
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City | VILLALBA
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State | PR
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Zip | 00766
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Country | US
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Telephone | 787-847-1234
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 755
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License Number State | PR
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