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General NPI Number Information
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NPI Number | 1851452866
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Entity Type | Individual
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Provider Name | GILBERTO R GEIGEL CERVONI PSY D
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Gender | Male
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 11/11/2016
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Provider Practice Location Address
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Address Line | 954 AVE PONCE DE LEON MIRAMAR PLAZA CENTER, SUITE 603
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City | SAN JUAN
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State | PR
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Zip | 00907-3646
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Country | US
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Telephone | 787-630-0555
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Fax |
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Provider Business Mailing Address
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Address Line | 222 CALLE POTOMAC URB EL PARAISO
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City | SAN JUAN
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State | PR
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Zip | 00926-2922
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Country | US
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Telephone | 787-630-0555
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1899
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License Number State | PR
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