Provider Demographics
NPI:1225047517
Name:GROSS, GLORIANNA ROMERO (MD)
Entity Type:Individual
Prefix:MRS
First Name:GLORIANNA
Middle Name:ROMERO
Last Name:GROSS
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:W17 CALLE CERRILLOS
Mailing Address - Street 2:COLINAS METROPOLITANAS
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5239
Mailing Address - Country:US
Mailing Address - Phone:787-627-8029
Mailing Address - Fax:
Practice Address - Street 1:W17 CALLE CERRILLOS
Practice Address - Street 2:COLINAS METROPOLITANAS
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5239
Practice Address - Country:US
Practice Address - Phone:787-627-8029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13208174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR21572Medicare ID - Type Unspecified