Provider Demographics
NPI:1972282150
Name:GUSTAVO R ALBIZU ANGULO PSC
Entity Type:Organization
Organization Name:GUSTAVO R ALBIZU ANGULO PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GUSTAVO
Authorized Official - Middle Name:R
Authorized Official - Last Name:ABIBUZO ANGULO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-862-8844
Mailing Address - Street 1:HC 03 BOX 31902
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-9031
Mailing Address - Country:US
Mailing Address - Phone:787-862-8844
Mailing Address - Fax:
Practice Address - Street 1:HC 03
Practice Address - Street 2:
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687-9031
Practice Address - Country:US
Practice Address - Phone:787-862-8844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GUSTAVO R ALBIZU ANGULO PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-14
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty