Provider Demographics
NPI:1972512879
Name:GIERBOLINI, MAYTTEE (TC, PV)
Entity Type:Individual
Prefix:MRS
First Name:MAYTTEE
Middle Name:
Last Name:GIERBOLINI
Suffix:
Gender:F
Credentials:TC, PV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 CALLE BALDORIOTY STE 4
Mailing Address - Street 2:PO BOX 2437
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-3120
Mailing Address - Country:US
Mailing Address - Phone:787-617-4564
Mailing Address - Fax:
Practice Address - Street 1:43 CALLE BALDORIOTY STE 4
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-3120
Practice Address - Country:US
Practice Address - Phone:787-617-4564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRN/A246XC2903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR246XC2903XOtherCARDIOVASCULAR TECNICAL