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NPI Code Detail

MEDICARE: CDT G.M,S.P., INC

MEDICARE: CDT G.M,S.P., INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician
2208000000XPediatrics Physician
3103TC0700XClinical Psychologist
4207Q00000XFamily Medicine Physician
5208D00000XGeneral Practice Physician
6261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
71041C0700XClinical Social Worker
8207QG0300XGeriatric Medicine (Family Medicine) Physician
9261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1255187159
Entity Type Code : Organization
Provider Name (Legal Business Name) : CDT G.M,S.P., INC
Provider Business Mailing Address
First Line : B7 CALLE SANTA CRUZ
Second Line :
City : BAYAMON
State : PR
Zip : 00961-6902
Country : US
Telephone Number : 787-780-9196
Fax Number :
Provider Business Practice Location Address
First Line : B7 CALLE SANTA CRUZ
Second Line :
City : BAYAMON
State : PR
Zip : 00961-6902
Country : US
Telephone Number : 787-780-9196
Fax Number :
Authorized Official
Title or Position : FACULTAD MEDICA
Name : DIANNETTE MALDONADO
Credential :
Telephone Number : 787-780-9196
Provider Enumeration Date : 04/30/2024
Last Update Date : 02/27/2026

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Directions to “CDT G.M,S.P., INC ” Practice Location

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