Organization
CDT GMSP INC
Active
Parent organization
CDT GMSP INC
Other names
Primary Care CDT GMSP, Inc
Organization subpart
Yes
Provider details
NPI number
Legal business name
CDT GMSP INC
Authorized official
DR. ILIA ZAYAS (EXECUTIVE DIRECTOR)
(787) 780-9196
Entity
Organization
Contact information
Practice address
B7 CALLE SANTA CRUZ, BAYAMON, PR 00961-6902
(787) 786-1325
Mailing address
B7 CALLE SANTA CRUZ, BAYAMON, PR 00961-6902
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94
DEPARTMENT OF HEALTH OF PUERTO RICO
PR
Enumeration date
07/22/2013
Last updated
11/16/2016
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