1184015836 NPI number — GPR ORTHOPEDICS PSC

Table of content: (NPI 1184015836)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184015836 NPI number — GPR ORTHOPEDICS PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GPR ORTHOPEDICS PSC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184015836
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
576 CALLE CESAR GONZALEZ
Provider Second Line Business Mailing Address:
SUITE 402
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00918-3756
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-767-5085
Provider Business Mailing Address Fax Number:
787-767-6876

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
576 CALLE CESAR GONZALEZ
Provider Second Line Business Practice Location Address:
SUITE 402
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918-3756
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-767-5085
Provider Business Practice Location Address Fax Number:
787-767-6876
Provider Enumeration Date:
02/16/2015

Additional Information

Authorized Official

Authorized Official Last Name:
PEREZ
Authorized Official First Name:
GERARDO
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-538-1034

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  12262 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1144233602 . This is a "NPI" identifier . This identifiers is of the category "OTHER".




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