Individual
MR. GUSTAVO ENRIQUE CAPO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S.
Contact information
Practice address
1025 WALNUT ST STE 1100, PHILADELPHIA, PA 19107-5001
(215) 955-1416
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-8623
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/11/2025
Last updated
05/01/2026
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