Individual
GUSTAVO JOSE MANGUAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LND,CDN
Contact information
Practice address
196 CALLE CASTANIA, PONCE, PR 00731-9565
(787) 638-4564
Mailing address
196 CALLE CASTANIA, PONCE, PR 00731-9565
(787) 638-4564
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
2184
PR
Other
Enumeration date
11/09/2023
Last updated
11/09/2023
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