Provider Demographics
NPI:1033223623
Name:JONES, GERTY (MD)
Entity Type:Individual
Prefix:DR
First Name:GERTY
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:B9 CALLE JADE
Mailing Address - Street 2:PARQUE SAN PATRICIO
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-3406
Mailing Address - Country:US
Mailing Address - Phone:787-608-6001
Mailing Address - Fax:
Practice Address - Street 1:1003 CARR 2 KM.45
Practice Address - Street 2:SECTOR CANTERA
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-4843
Practice Address - Country:US
Practice Address - Phone:787-608-6001
Practice Address - Fax:787-924-0751
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7265208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0081885Medicare PIN
PR81885Medicare ID - Type Unspecified