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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