Provider Demographics
NPI:1770189029
Name:G&S MEDICAL OFFICE PSC
Entity Type:Organization
Organization Name:G&S MEDICAL OFFICE PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GILMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:939-639-0557
Mailing Address - Street 1:PO BOX 1953
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-1953
Mailing Address - Country:US
Mailing Address - Phone:939-639-0557
Mailing Address - Fax:787-551-4052
Practice Address - Street 1:CARRETERA 111, KM 2.3
Practice Address - Street 2:BARRIO PALMAR
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-0998
Practice Address - Country:US
Practice Address - Phone:939-639-0557
Practice Address - Fax:787-551-4052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty