Provider Demographics
NPI:1356104442
Name:MONTALVO NOGUERA, GABRIELA SOFIA
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:SOFIA
Last Name:MONTALVO NOGUERA
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:PASEO REAL, B STREET, D-5
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6483
Mailing Address - Country:US
Mailing Address - Phone:787-508-9020
Mailing Address - Fax:
Practice Address - Street 1:PASEO REAL, B STREET, D-5
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6483
Practice Address - Country:US
Practice Address - Phone:787-508-9020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program