Organization
GASTROVEM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VASCO EGUIA MOREDA MD (PRESIDENT OWNER)
(787) 633-5263
Entity
Organization
Contact information
Practice address
1607 AVE PONCE DE LEON STE GM04, SAN JUAN, PR 00909-1803
(787) 910-0909
(888) 588-0319
Mailing address
1353 AVE LUIS VIGOREAUX PMB 757, GUAYNABO, PR 00966-2715
(787) 910-0909
(888) 588-0319
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037939901
—
PR
Enumeration date
10/16/2013
Last updated
07/27/2021
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