Provider Demographics
NPI:1760642599
Name:GRUPO GASTROENTEROLOGICO DEL CARIBE, CSP
Entity Type:Organization
Organization Name:GRUPO GASTROENTEROLOGICO DEL CARIBE, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-525-0842
Mailing Address - Street 1:E6 VIA LADERAS
Mailing Address - Street 2:LA VISTA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-4467
Mailing Address - Country:US
Mailing Address - Phone:787-525-0842
Mailing Address - Fax:
Practice Address - Street 1:AVE SANCHEZ OSORIO
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-3226
Practice Address - Country:US
Practice Address - Phone:787-525-0842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15951261QE0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy