Provider Demographics
NPI:1164413910
Name:GEMEFA INC.
Entity Type:Organization
Organization Name:GEMEFA INC.
Other - Org Name:CLINICA DE SALUD DEL TURABO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT GEMEFA INC
Authorized Official - Prefix:
Authorized Official - First Name:MAXIMINO
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRANDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-737-6441
Mailing Address - Street 1:PO BOX 1262
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-737-6441
Mailing Address - Fax:787-737-1280
Practice Address - Street 1:CALLE ANDRES ARUZ RIVERA OESTE
Practice Address - Street 2:#166
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778
Practice Address - Country:US
Practice Address - Phone:787-737-6441
Practice Address - Fax:787-737-1280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-01
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0081033Medicare PIN