MEDICARE: DR. GILBERTO R GEIGEL CERVONI PSY D

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	103TC0700X	Clinical Psychologist	1899	PR

General Provider Information

NPI Number	:	1851452866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GILBERTO R GEIGEL CERVONI PSY D

Provider Business Mailing Address
First Line	:	222 CALLE POTOMAC
Second Line	:	URB EL PARAISO
City	:	SAN JUAN
State	:	PR
Zip	:	00926-2922
Country	:	US
Telephone Number	:	787-630-0555
Fax Number	:

Provider Business Practice Location Address
First Line	:	954 AVE PONCE DE LEON
Second Line	:	MIRAMAR PLAZA CENTER, SUITE 603
City	:	SAN JUAN
State	:	PR
Zip	:	00907-3646
Country	:	US
Telephone Number	:	787-630-0555
Fax Number	:

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	11/11/2016

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