Provider Demographics
NPI:1134281926
Name:MATERNITY GYN INC
Entity Type:Organization
Organization Name:MATERNITY GYN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GIOVANNI
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-854-7531
Mailing Address - Street 1:PO BOX 9784
Mailing Address - Street 2:COTTO STATION
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-9784
Mailing Address - Country:US
Mailing Address - Phone:787-854-7531
Mailing Address - Fax:787-884-8753
Practice Address - Street 1:B42 CALLE ELLIOT VELEZ
Practice Address - Street 2:URBANIZACION ATENAS
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-7531
Practice Address - Fax:787-884-8753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8124207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
04578OtherAMERICAN HEALTH INC
069557OtherCRUZ AZUL
04578OtherAMERICAN HEALTH INC
F47615Medicare UPIN