Provider Demographics
NPI:1922731249
Name:RUBIO VEGA, GABRIELA LORRAINE
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:LORRAINE
Last Name:RUBIO VEGA
Suffix:
Gender:F
Credentials:
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 9734
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-9734
Mailing Address - Country:US
Mailing Address - Phone:787-509-6381
Mailing Address - Fax:
Practice Address - Street 1:100 CALLE GUADALUPE
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-3729
Practice Address - Country:US
Practice Address - Phone:787-844-5656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty