Organization
INNOVATIVE WEIGHT LOSS SOLUTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FEDERICO GREGORY-GONZALEZ MD (PRESIDENT)
(787) 946-5220
Entity
Organization
Contact information
Practice address
101 AVE SAN PATRICIO STE 1050, GUAYNABO, PR 00968-3049
(787) 946-5220
(787) 946-5220
Mailing address
1353 AVE. LUIS VIGOREAUX, PMB 466, GUAYNABO, PR 00966
(787) 946-5220
(787) 946-5220
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
14704
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14704
MD
PR
Enumeration date
03/03/2016
Last updated
03/03/2016
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