# GSM-SALUD PRIMARIA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GSM-Salud Primaria
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376202366
- **Authorized official:** DR. VASCO EGUIA MOREDA (PRESIDENT OWNER)
- **Authorized official phone:** (787) 633-5263

## Contact information

- **Practice address:** 1607 AVE PONCE DE LEON STE GM4, SAN JUAN, PR 00909-1803
- **Practice address phone:** (787) 910-0909
- **Practice address fax:** (888) 588-0319
- **Mailing address:** 1353 AVE LUIS VIGOREAUX PMB 757, GUAYNABO, PR 00966-2715

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 12/17/2021
- **Last updated:** 12/21/2021