Individual
GUILLERMO DANIEL MORAN GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MDMG
Contact information
Practice address
URB VILLA BORINQUEN, CALLE NITAINO G-37, CAGUAS, PR 00725
(787) 595-6655
Mailing address
PO BOX 1398, JUNCOS, PR 00777-1398
(787) 595-6655
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
4980116
PR
343900000X
Non-emergency Medical Transport (VAN)
4980116
PR
347C00000X
Private Vehicle
4980116
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90909
—
PR
Enumeration date
03/30/2022
Last updated
04/06/2022
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