# GOLD STAR MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073289922
- **Authorized official:** SHAHID M CHAUDHARY MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (787) 673-1238

## Contact information

- **Practice address:** 2 AVE LUIS MUNOZ MARIN, HORMIGUEROS, PR 00660-1750
- **Practice address phone:** (787) 673-1238
- **Mailing address:** \#184 CALLE VALENCIA, URB. LA SALAMANCA, SAN GERMAN, PR 00683
- **Mailing address phone:** (787) 673-1238

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QR0200X | Radiology Clinic/Center | — | NULL | — |
| 291U00000X | Clinical Medical Laboratory | — | NULL | — |

## Other

- **Enumeration date:** 08/20/2021
- **Last updated:** 09/11/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 371248 | REGISTER NUMBER | PR |