Organization
GARY G MONTALVO PETROVICH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY G MONTALVO M.D. (DUENO)
(787) 754-8625
Entity
Organization
Contact information
Practice address
400 AVE DOMENECH STE 506, LAS AMERICAS PROF CENTER, SAN JUAN, PR 00918-0000
(787) 754-8625
(787) 754-8648
Mailing address
PO BOX 8465, CAGUAS, PR 00726-8465
(787) 754-8625
(787) 754-8648
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
5622
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5622
LIC
PR
Enumeration date
06/17/2014
Last updated
06/17/2014
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