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NPI Code Detail

MEDICARE: CDT GMSP INC

MEDICARE: CDT GMSP 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
12085R0202XDiagnostic Radiology Physician
2261QH0100XHealth Service Clinic/Center
3261QU0200XUrgent Care Clinic/CenterPR
4291U00000XClinical Medical Laboratory
5261QF0400XFederally Qualified Health Center (FQHC)

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
20056768OTHERPRMEDICARE PROVIDER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417922972
Entity Type Code : Organization
Provider Name (Legal Business Name) : CDT GMSP INC
Provider Business Mailing Address
First Line : B7 CALLE SANTA CRUZ
Second Line :
City : BAYAMON
State : PR
Zip : 00961-6902
Country : US
Telephone Number : 787-786-1325
Fax Number : 787-625-6124
Provider Business Practice Location Address
First Line : B7 CALLE SANTA CRUZ
Second Line :
City : BAYAMON
State : PR
Zip : 00961-6902
Country : US
Telephone Number : 787-786-1325
Fax Number : 787-625-6124
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : DR. ILIA E ZAYAS
Credential : MD, MPH
Telephone Number : 787-780-9196
Provider Enumeration Date : 02/20/2006
Last Update Date : 02/06/2026

Similar Medicare Providers

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Practice Location Address:
B7 CALLE SANTA CRUZ
BAYAMON, PR
00961-6902
Practice Phone: 787-780-9196
Practice Fax:
1073955951 — MULTISPECIALTY GROUP CDT GMSP INC
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BAYAMON, PR
00961-6902
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1861629628 — CDT GMSP INC
Practice Location Address:
B7 CALLE SANTA CRUZ
BAYAMON, PR
00961-6902
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Practice Fax:
1912341884 — CDT G.M,S.P., INC
Practice Location Address:
B7 CALLE SANTA CRUZ
BAYAMON, PR
00961-6902
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Practice Fax:
1790750529 — CDT GMSP, INC
Practice Location Address:
B7 CALLE SANTA CRUZ , AVE. SANTA CRUZ
BAYAMON, PR
00961-6902
Practice Phone: 787-780-9196
Practice Fax: 787-625-6120
1609841436 — CDT G.M,S.P., INC RADIOLOGIA
Practice Location Address:
B7 CALLE SANTA CRUZ , AVE SANTA CRUZ
BAYAMON, PR
00961-6902
Practice Phone: 787-786-1325
Practice Fax: 787-778-4793

Directions to “CDT GMSP INC ” Practice Location

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