MEDICARE: GABRIEL HIRAM VALDES GUTIERREZ

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
1	111N00000X	Chiropractor	1167	PR

General Provider Information

NPI Number	:	1841133709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIEL HIRAM VALDES GUTIERREZ

Provider Business Mailing Address
First Line	:	408 SAVANNAH REAL
Second Line	:
City	:	SAN LORENZO
State	:	PR
Zip	:	00754-4133
Country	:	US
Telephone Number	:	787-914-7831
Fax Number	:

Provider Business Practice Location Address
First Line	:	408 SAVANNAH REAL
Second Line	:
City	:	SAN LORENZO
State	:	PR
Zip	:	00754-4133
Country	:	US
Telephone Number	:	787-914-7831
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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