Provider Demographics
NPI:1700925302
Name:COMPLETE NEURO GNM, PSC
Entity Type:Organization
Organization Name:COMPLETE NEURO GNM, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GIAN
Authorized Official - Middle Name:CARLO
Authorized Official - Last Name:GIERBOLINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-621-3737
Mailing Address - Street 1:PMB 125
Mailing Address - Street 2:19.22 AVENIDA RAMIREZ DE ARELLANO
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-621-3737
Mailing Address - Fax:787-621-3251
Practice Address - Street 1:MANATI MEDICAL CENTER
Practice Address - Street 2:SUITE 201
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-621-3737
Practice Address - Fax:787-621-3251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0163432084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR23964 GIMedicare ID - Type Unspecified