Provider Demographics
NPI:1184204232
Name:SEDA POMBROL, GABRIEL EUGENIO
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:EUGENIO
Last Name:SEDA POMBROL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVE LUIS VIGOREAUX COND ASSISI 1010
Mailing Address - Street 2:APT 22
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:407-683-9508
Mailing Address - Fax:
Practice Address - Street 1:CARR. #2 KM. 173
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-892-1860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program