Provider Demographics
NPI:1164771622
Name:GYBELLE, PC
Entity Type:Organization
Organization Name:GYBELLE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TULLA LLAUGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-423-7377
Mailing Address - Street 1:101 AVE SAN PATRICIO
Mailing Address - Street 2:MARAMAR PLAZA SUITE 1090
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-2645
Mailing Address - Country:US
Mailing Address - Phone:787-423-7377
Mailing Address - Fax:787-848-0318
Practice Address - Street 1:101 AVE SAN PATRICIO
Practice Address - Street 2:MARAMAR PLAZA SUITE 1090
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-2645
Practice Address - Country:US
Practice Address - Phone:787-423-7377
Practice Address - Fax:787-848-0318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17604207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty