Provider Demographics
NPI:1356446959
Name:ENRIQUEZ-FIGUEROA, GRETCHEN (MD)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:ENRIQUEZ-FIGUEROA
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:PO BOX 6613
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-6613
Mailing Address - Country:US
Mailing Address - Phone:787-254-3216
Mailing Address - Fax:
Practice Address - Street 1:410 AVE. HOSTOS SUITE #7
Practice Address - Street 2:ASSMCA
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1522
Practice Address - Country:US
Practice Address - Phone:787-833-0663
Practice Address - Fax:787-833-1371
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14350208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice