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Organization

CDT GMSP INC

Active
Other names
CDT GMSP
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ILIA E ZAYAS MD, MPH (EXECUTIVE DIRECTOR)
(787) 780-9196
Entity
Organization

Contact information

Practice address
B7 CALLE SANTA CRUZ, BAYAMON, PR 00961-6902
(787) 786-1325
(787) 625-6124
Mailing address
B7 CALLE SANTA CRUZ, BAYAMON, PR 00961-6902
(787) 786-1325
(787) 625-6124

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
261QH0100X
Health Service Clinic/Center
261QU0200X
Urgent Care Clinic/Center
PR
291U00000X
Clinical Medical Laboratory

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0056768
MEDICARE PROVIDER
PR
05
037468400
PR
Enumeration date
02/20/2006
Last updated
02/06/2026
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