Provider Demographics
NPI:1891417770
Name:VARGAS, GABRIEL ANDRES
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:ANDRES
Last Name:VARGAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1961 CALLE SANDALO
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3940
Mailing Address - Country:US
Mailing Address - Phone:787-307-0095
Mailing Address - Fax:
Practice Address - Street 1:1961 CALLE SANDALO
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-3940
Practice Address - Country:US
Practice Address - Phone:787-307-0095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program