Provider Demographics
NPI:1356767990
Name:PLATINUM GI CONSULTING SERVICES, INC
Entity type:Organization
Organization Name:PLATINUM GI CONSULTING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:GINES
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTINEZ MANGUAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-691-1201
Mailing Address - Street 1:PO BOX 6569
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-6569
Mailing Address - Country:US
Mailing Address - Phone:787-744-6590
Mailing Address - Fax:787-961-4686
Practice Address - Street 1:100 AVE LUIS MUNOZ MARIN
Practice Address - Street 2:SUITE 150 URB. MARIOLGA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-6184
Practice Address - Country:US
Practice Address - Phone:787-744-6590
Practice Address - Fax:787-961-4686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-06
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8842207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty