Organization
CDT G.M,S.P., INC
Active
Organization
CDT G.M,S.P., INC
Active
Other names
CLINICA NUTRICION CDT G.M.S.P., INC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ILIA ZAYAS (EXCUTIVE DIRECTOR)
(787) 780-9196
Entity
Organization
Contact information
Practice address
B7 CALLE SANTA CRUZ, BAYAMON, PR 00961-6902
(787) 780-9196
Mailing address
B7 CALLE SANTA CRUZ, BAYAMON, PR 00961-6902
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037582600
—
PR
01
—
FL377A
FIRST COAST PTAN
—
Enumeration date
04/23/2013
Last updated
02/06/2026
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