Organization
SAN GERARDO MEDICAL CENTER CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALDO GONZALEZ MD (OWNER)
(787) 897-0560
Entity
Organization
Contact information
Practice address
CARR 129 KM 27.3 BO PUEBLO, LARES, PR 00669
(787) 897-0560
Mailing address
PO BOX 916, LARES, PR 00669-0916
(787) 897-0560
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10885
TRIPLE- S
PR
Enumeration date
11/13/2007
Last updated
11/13/2007
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