Provider Demographics
NPI:1851704589
Name:MONTALVO-CASTRO, GABRIEL (MD)
Entity Type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:
Last Name:MONTALVO-CASTRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 360160
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-0160
Mailing Address - Country:US
Mailing Address - Phone:787-787-5151
Mailing Address - Fax:
Practice Address - Street 1:66 CALLE SANTA CRUZ
Practice Address - Street 2:INSTITUTO SAN PABLO SUITE 307
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-798-8486
Practice Address - Fax:787-740-7170
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME141853208D00000X
NY316085208D00000X
PR19155208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice