Organization
NEURO GI WELLNESS CENTRE, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY GONZALEZ-RIVERA M.D (PRESIDENT)
(787) 283-0408
Entity
Organization
Contact information
Practice address
200 AVE WINSTON CHURCHILL STE 201, SAN JUAN, PR 00926-6655
(787) 283-0804
(787) 761-5764
Mailing address
PO BOX 1132, TRUJILLO ALTO, PR 00977-1132
(787) 283-0804
(787) 761-5764
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
12865
PR
207RG0100X
Gastroenterology Physician
Primary
12278
PR
208VP0000X
Pain Medicine Physician
12865
PR
Other
Enumeration date
07/16/2014
Last updated
07/17/2014
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