Individual
JOSE A. GAUDIER DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
40A CALLE ORQUIDEA, CANOVANAS, PR 00729-3540
(787) 256-5659
Mailing address
40A CALLE ORQUIDEA, CANOVANAS, PR 00729-3540
(787) 256-5659
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
21679
PR
208000000X
Pediatrics Physician
21679
PR
208D00000X
General Practice Physician
Primary
21679
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21679
JUNA DE LICENCIAMIENTO DE PUERTO RICO
PR
Enumeration date
06/01/2016
Last updated
11/28/2022
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